According to information published by Dentagraphics, Pennsylvania has 3,716 general dental practices and 1,705 specialty dental practices. Spread out across these are 9,245 dentists licensed in the state. The United States Census Bureau estimates the state to have approximately 12.8 million residents in 2019, which produces a ratio of 1,385 Pennsylvanians per dentist. However, the government’s Health Resources & Services Administration determined that there are 149 Dental Health Professional Shortage Areas within the state.
Despite these pockets where dentists are less plentiful, the state has a robust dental plan market as the following section demonstrates.
An analysis of 33 dental plans offered in the state of Pennsylvania for 2021 found dental coverage in a variety of forms:
HMOs and Discount programs have the most restrictive dental networks. Normally care received outside of these networks is not covered. PPOs, in contrast, provide the freedom to use out-of-network dentists but this comes with higher out-of-pocket costs. Indemnity plans also do not restrict enrollees to a network but may require them to complete and submit claims forms for reimbursement.
The 33 plans analyzed for this article represented nine separate insurers:
Premiums and deductibles were compared given a standardized applicant profile. The least expensive offering within the study had a monthly premium of $7.89 a month. This plan was Dominion National’s “Select Plan Basic DHMO. The most expensive was Nationwide’s Classic 2000 indemnity dental plan. This plan had a monthly premium of 68.72. Monthly premium averaged $33.83 when all premiums were taken into consideration.
Deductibles were inconsistent among plans. Some plans had either no deductible or a deductible that was waived for certain preventive services. A deductible for a single individual ranged from $25 to $150 (though it should be noted that the single plan with the $150 deductible had this deductible apply once for as long as the member stayed enrolled in the plan instead of resetting each year as most traditional deductibles do).
Family deductibles were more expensive than individual deductibles, as would be expected. Some plans charged a $50 annual deductible for each family member enrolled. Other plans capped the maximum annual deductible for a family. These capped family deductibles were as low as $75 and as high as $450 (the high deductible was only paid once for as long as the family stayed enrolled within the plan).
While the 33 plans reviewed covered preventive care, minor dental procedures, major dental procedures, and orthodontic care, there was no uniformity of benefits among the different plans. The lowest priced plans generally had higher cost-sharing and network restrictions or reduced benefits when compared to more expensive offerings but exceptions were certainly present.
The Pennsylvania Dental Association, otherwise known by the acronym PDA, is a professional association with about 6,000 members from the dental field. The mission of the organization is to "serve the public, improve their health, promote the art and science of dentistry and represent the interests of its members and the people they serve.” A recent press release from the organization educated the public on how to find and choose the right dentist.
The Pennsylvania Dental Association provides an online resource that directs consumers to information regarding:
This tool enables a Pennsylvanian to select his or her county and see a list of dental clinics that are free or use a sliding scale for costs based on ability to pay.
Virtue, liberty, and independence
Graded benefit year maximums
Plan type: PPO
Plan Maximum: $500 – $1000
Use one of our 115,000 network providers to get the most from this plan. No waiting periods.
Plan type: PPO
Plan Maximum: $2000
Immediate coverage with no waiting periods for most services. Generous plan maximum.
Plan type: PPO
Plan Maximum: $3000