A review of 23 plans from seven popular dental insurance companies in Oregon revealed several trends regarding coverage and costs. Two were HMO dental plans, one a dental discount card, and 20 were PPO dental plans. The insurers including in the review were:
The average premium among the plans reviewed was $40.34 a month for a 30 year-old living in Portland. Three of the plans had no annual limits on insurer spending or cumulative discounts (Dental Health Services SmartSmile DHMO, Dental Health Services Super SmartSmile DHMO, Careington 500 Series Dental Savings). For plans that did have a cap on the amount the insurer paid for dental care per year, the average was $1,662.50. One plan, Ameritas Hollywood Smile Premier 2500 PPO, had an annual limit of $2,500 while its premium was only $27.13, well below the average of $40.34 a month.
While there was a general trend that higher premium plans had higher annual limits (called the "maximum benefit"), there were many exceptions. The NCD Nationwide 5000 Plan PPO had the highest annual limit of $5,000 and was the most expensive plan in the study, there were several plans in the highest cost group that only had an annual limit of $1,500, which was below the average across all the plans reviewed. Some plans had limits that increased when the enrollee entered the second and third year of coverage. Our average was based on the first year of coverage. HMO plans and discount cards, as noted earlier, had no annual limits.
Most plans covered fillings using a co-insurance fee to determine the patient's out-of-pocket cost. A co-insurance fee represents a portion of the total cost of the dental service. For example, if the plan has an 80% coinsurance for a filling then the patient pays the remaining 20% of the cost. Three plans (the two HMOs and the one discount card) charged a flat fee for fillings in the range of $47 to $83. Among the other plans using coinsurance, the average coinsurance was 66% which left the remaining 34% of the filling cost to the patient. Nine of the plans had a coinsurance of 80%, leaving only 20% of the cost to the patient.
With respect to plan popularity, below are the bestselling plans in Oregon according to DentalInsurance.com sales figures. To see plans offered in your area, visit our home page and compare dental plans.
Rich benefits with maximums increase each for year the first 3 years.
Plan type: PPO
Plan Maximum: $1000 – $1500
100% preventive coverage on day one. $2000 plan maximum. No waiting periods.
Plan type: PPO
Plan Maximum: $2000
No Waiting Periods for Preventive and Basic services
Plan type: PPO
Plan Maximum: $1500
The Oregon Dental Association is a professional society that promotes both high standards among dentists as well as oral health among the patients they serve. The association is composed of 16 separate dental societies in the state.
The Oregon Oral Health Coalition is a nonprofit dedicated to improving Oregon's oral health by sharing their vision with leaders in health care, government, business, philanthropy, nonprofit and the community.
This directory of dental clinics contains 214 low-cost/no-cost options serving low-income as well as uninsured Oregonians.
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