Texas Dental Insurance

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How to Save on The Best Dental Insurance in Texas

By Insurance Industry Expert & Author

Updated on

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In this article

With approximately 29 million residents and 15,000 dentists, Texas supports a competitive dental insurance market. In order to choose the right plan for your circumstances, this article will teach you the basics regarding:

With this information, you can move from shopping on premium alone to comparing dental plans’ value for your dollar.

The Best Texas Dental Insurance According to Sales

Below are the three most popular Texas dental plans based on DentalInsurance.com's 2024 sales data.

Company logo for Guardian bestselling

Advantage Achiever

Rich benefits with maximums increase each for year the first 3 years

Plan Type: PPO

Plan Maximum: $1000 - $1500

Company logo for Delta Dental bestselling

Immediate Coverage Plan

Immediate coverage with no waiting periods for most services. Generous plan maximum.

Plan Type: PPO

Plan Maximum: $3000

Company logo for Ameritas bestselling

Hollywood Smile Premier Plus 2000

100% preventive coverage on day one. $2000 plan maximum. No waiting periods.

Plan Type: PPO

Plan Maximum: $2000

The Cost of Dental Insurance in Texas

Average Premiums & Plans Priced Under $10 a Month

A review of 38 dental plans in the Lone Star State found a considerable range of prices. The average premium in 2022 was $40.83 for a 33 year-old sample applicant, but the lowest monthly premium was $7.03 for the MetLife TakeAlong Dental HMO-Managed Care 350 (Low). Every HMO dental insurance plan premium in the study fell below the state average as did the one dental discount program in the study (Careington 500 Series Dental Savings). Among PPO and indemnity dental plans, 16 out of 33 had premiums below the study average.

Out-of-Pocket Fees for Covered Dental Services

Two-thirds (69.2 percent) of the 39 plans covered routine dental cleanings without charging any copayment or other out-of-pocket fee. During the first year of enrollment, most of the plans covered root canals and crowns paid for 36.1 percent of the treatment cost. Several of the dental plans increased this coverage percentage for customers who stayed in the plan for two and three years in a row. For HMO plans whose out-of-pocket costs were flat-fee copayments, the price for a root canal ranged from $110 to $260, with a $192.50 average cost for the patient. The sole dental discount program, Careington 500 Series Dental Savings, had its root canal charge begin at $320.

Teeth extractions had higher coverage from PPO and indemnity plans than was the case for root canals and crowns, with insurer payments averaging 45 percent of cost. Insurer payments toward fillings were even higher, at a 62.4 percent of the procedure cost. HMO dental plans copayments for fillings ranged from $25 to $36.

43.6 percent of all plans in the study examined had some level of coverage for dental implants. Most of the plans with implant coverage paid for 50 percent of the procedure (assuming the deductible was satisfied). Three of the plans with implant coverage only provided for 20 percent of the treatment cost and one plan only covered 10 percent. 70.6 percent of dental plans that included implant coverage imposed a minimum enrollment length before their dental implant coverage became active. Such a delay in benefit access is known as a “waiting period.” Waiting periods were common (especially for more expensive dental care) among the 39 plans under consideration, with 33.3 percent having no waiting period delays for traditional dental coverage (orthodontics excluded).

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All the PPO dental plans and indemnity dental plans had restrictions on how much money the insurance company would pay annually toward dental treatment. The average amount among these plans was $1,976. The NCD Nationwide 5000 Plan had a limit over two times higher than the average at $5,000, and the NCD Complete by MetLife, at $10,000, had a maximum benefit roughly five times the market average. Both the HMO plans and dental discount program in the study had no annual limits regarding insurer payments or customer savings.

These differences in insurer payment limits warrants some brief comments regarding different types of dental plans. A HMO is a dental health maintenance organization where care is covered when provided by in-network dentists and care outside the network is not covered. An indemnity plan, in contrast, does not limit the enrollee to specific dentists. However, an indemnity plan has a reimbursement scheme for dental services that may be lower than what a dentist charges. Within a HMO, the enrollee has fixed copayments (or, more rarely, coinsurance fees) that have been agreed upon by the dentists within the plan's network. Another form dental coverage is the dental preferred provider organization (PPO), the most common model of dental network, where in-network dentists have lower copays and cost-sharing than dentists who are out-of-network. In contrast, a HMO dental plan will normally not cover out-of-network dental care and their networks are typically smaller than is the case for PPO networks.

Deductibles

Out-of-pocket costs come in many forms: deductibles, flat fee copayments, and coinsurance fees (where the patient pays for a percentage of the dental service). A deductible is the money you pay your dentist before an insurance plan begins to share in covered dental treatment costs. If a policy has a $100 deductible then a patient pays the first $100 of dental care expenses during the coverage period (i.e. the plan year). After the deductible has been paid, the insurance company pays its portion of the dental service cost while the patient pays a copayment or coinsurance fee. When a new plan year begins, the process starts all over with respect to the deductible.

In Texas, deductibles varied, but within a relatively narrow range. The smallest deductible observed among the plans studied was $0. In fact, one-in-five plans examined charged no deductible ($0) to enrollees. The highest annual deductible for an individual was $100, though a single plan had a one-time individual deductible of $150. The average deductible for a single enrollee was $50 a year. Family deductibles were higher and often depended on the number of family members enrolled in the plan.

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Teeth Whitening

Teeth whitening is a form of cosmetic dentistry and most plans do not cover cosmetic dental services. However, a review of 39 Texas plans found that 20.5 percent had some form of coverage for teeth whitening. Many industry experts believe that teeth whitening coverage with become more common in the future.

Companies Providing Texas Dental Plans

The 39 plans reviewed as part of this study came from the following ten insurance companies: Ameritas, Careington, Delta Dental, Guardian Dental, Humana Dental, MetLife Dental, NCD by MetLife, and Renaissance Dental.

You're Ready to Compare Texas Dental Insurance Plans

Now that you’re more educated consumer regarding the Texas dental insurance market, you’re in a better position to judge the value of your dental insurance options in the Lone Star State. To review dental insurance prices in your region of Texas, you can visit our dental insurance quote page. You can also review below the most popular Texas dental insurance plans sold on DentalInsurance.com.

Need some help choosing a dental plan?

Our agents can:

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Dental Plan Details chart in Texas for this Study

The following chart provides additional details on the coverage trend in our Texas dental plan study. You can use this information when evaluating the breadth of coverage provided in a dental plan you are considering for purchase. The chart helps you recognize when a plan’s feature (e.g. premium, maximum benefit, etc.) are above or below the averages for the state.

Chart of Texas Dental Plan information
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Oral Health Resources for Texas Residents

We've pulled together information to help you find resources in your state to help you maintain your oral health.

Texas Dental Association (TDA)

Chartered in 1871, the TDA is the third largest state dental association in the United States. Currently, it has more than 9,000 members and is comprised of 26 dental societies grouped into 4 divisions across the state.

Texas Dental Resources

Helpful information regarding dental health, assistance for teaching children about proper oral health, dental emergencies, and one-minute videos on a variety of dental topics.

TDA Smiles Foundation

The Texas Dental Association sponsors the TDA Smiles Foundation, a program that expands access to dental health services to underserved communities in the state. The TDA Smiles Foundation accomplishes its work through several organizations including the Texas Mission of Mercy providing charitable dental care through dental clinic events across Texas, the Fluoride Fest and the Cavity Free Corral delivering oral health information to families, and SMART Smiles, which provides preventive dental services to elementary school aged children and low-income children.

Frequently Asked Questions

Do Texas Dental Plans Have Waiting Periods?

Two thirds of the 39 dental plans examined in Texas had waiting periods for one or more covered dental services. The waiting period length varied by plan and by specific services. The shortest waiting period was three months and the longest was eighteen months. Waiting periods are usually applied to more expensive services such as dental implants, root canals or crowns. These are known as major dental services. Waiting periods can also apply, though less frequently, on basic dental care such as fillings. It is unusual to see a waiting period on preventive care such as annual cleanings and dental exams.

Where can one learn more about the different types of insurance offered?

Dental Insurance 101 provides a solid introduction to dental insurance plans and their various features. Additionally, we have an article dedicated to the differences between PPO dental insurance and HMO dental insurance.

What is the annual maximum coverage amount for each plan?

A maximum coverage amount, otherwise known as a maximum benefit, is the dollar limit on insurance company spending for covered services within a plan year. Indemnity and PPO dental insurance have maximum coverage amounts while dental savings plans and HMO dental plans do not. Among the 39 Texas plans we examined, 87.2 percent had maximum coverage amounts, with the lowest being $500 annually and the largest $10,000. The average maximum amount per year was $1,976.

What are the plan types and coinsurance options for each plan?

The dental plan types examined in Texas were Preferred Provider Organizations (PPO), Health Maintenance Organizations (HMO), Dental Savings Programs, and plans that bundled dental plans with non-dental benefits such as vision and hearing care.

What are the age requirements for getting a dental insurance quote?

While people of any age can use our free dental insurance quoting service, you must be an adult to apply for a plan’s coverage. In some cases, an insurer may offer “child only” coverage where a dependent child is insured but in most cases at least one adult needs to be insured alongside children on a dental plan.

What does Texas dental insurance cost?

When examining 39 plans offered across the state of Texas, we found the average dental premium to be $40.15 a month for a 33-year-old applicant. Inasmuch as this was the average, there were many options less expensive and more expensive than this amount. The lowest monthly premium we observed for our applicant profile was $7.03 a month while the highest priced was $93.99.

What are the out-of-pocket costs for Texas dental insurance?

With respect to out-of-pocket costs, the average deductible for a single enrollee was $50 among 39 Texas dental plans examined. Most plans charged a deductible, though 20.5 percent of plans did not have a deductible. Family plans often charged a deductible per enrollee, though some capped the maximum deductible that may be charged a family regardless of enrollees.

HMO plans often charged fixed dollar copayments for covered dental treatments while PPO plans often used coinsurance fees which determined a patient’s out-of-pocket costs as a percentage of the service price.

Does a Dental Plan Have the Same Price in Every Region of Texas?

Not necessarily. There are local differences not only in the price of dentistry but there are also differences in dental service usage across the state. These regional differences means the same plan can have more expenses in one area versus another. An insurance company may decide to vary its rates by region because of this situation, though they may choose to have a single rate across the entire state.

Can I Use My Texas Dental Plan Out-of-State?

In some cases you may be able to do so. You would need to contact your insurance plan first and verify that an out-of-state dentist is in-network and then see if there are any conditions prohibiting your use of a dentist outside your state of residence.

If you are traveling outside of your country, it is unlikely that your plan will cover international care. If you do have a dental emergency while traveling overseas, contact your plan’s customer service team to understand your options.

I've Heard Someone Say Dental Insurance Isn’t Worth the Cost. Is that True?

Insurance may not always lower your costs because part of its value is to protect from large unanticipated expenses. This is the case whether you are discussing dental insurance or car insurance. However, with a dental plan the insurance company negotiates lower rates for procedures within its network of dentists. This can save considerable money off of the retail price of dental work.

What is a DHMO?

A DHMO is another name for a dental insurance health maintenance organization. A DHMO is a form of dental coverage where dental services are delivered through a network of dentists that is usually smaller than is the case for PPO dental plans. The DHMO dentists receive a fixed monthly fee per patient and then receive copayments from patients when they receive care. This type of arrangement is also referred to as a "capitation plan." HMO dental insurance is often the least expensive dental plan option and it has the further virtue of lacking a “maximum benefit.” A maximum benefit is an annual cap on how much an insurance company will pay toward patient care.

Need help choosing a plan? Call us at 800-296-3800

Our knowledgeable customer service team will assist you with any questions you may have prior to enrolling in a dental plan. They can guide you through the process of choosing coverage that matches your needs as well as your budget.

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