Texas Dental Insurance Plans

How to Shop for The Best Dental Plan in Texas

With approximately 29 million residents and 15,000 dentists, Texas supports a robust dental insurance marketplace with a ratio of about 1,900 residents for every one dentist located in the state. In order to choose the right plan for your circumstances, this article will teach you the basics regarding:

• Cost trends among Texas dental plans
• How plans differ in coverage for the same dental service
• Strategies to avoid expensive out-of-pocket costs
• Which dental plans are the bestsellers in Texas according to DentalInsurance.com sales figures

With this information, you can move beyond comparing prices to comparing value.

Average Premiums & Plans Priced Under $10 a Month

A review of nearly three dozen dental plans in the state of Texas found considerable range of prices. The average premium in 2022 was $39.25 for an individual enrollee, 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 average as did the one dental discount program in the study (Careington 500 Series Dental Savings). Among types of dental plans, 21 out of 35 had premiums below the study average.

Out-of-Pocket Fees for Covered Dental Services

Two-out-of-three (66 percent) of the 35 plans covered routine dental cleanings without charging any copayment or other out-of-pocket fee. During the first year of enrollment, most of the that plans covered root canals and crowns paid for 41 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. The sole dental discount program, Careington 500 Series Dental Savings, charged $320 for a root canal.

Teeth extractions had higher coverage, averaging 56 percent of cost, and fillings were even higher at a 61 percent of cost average. HMO dental plans copayments for fillings ranged from $25 to $60.

40 percent of plans examined had some level of coverage for dental implants. Most of the plans with crown coverage paid for 50 percent of the crown cost. 4 of the plans with implant coverage only provided for 20 percent of the costs. 71 percent of dental plans that included implant coverage required the customer to be enrolled in the plan for at least a year before crown coverage was available. A delay in benefit access is known as a “waiting period.” Waiting periods were common (especially for more expensive dental care) among the 35 plans under consideration, with 34 percent having no waiting period delays for the coverage they offered.

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 $1,590 for 2022. The NCD Nationwide 5000 Plan had a limit three times higher than the average at $5,000. 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 your policy has a $100 deductible then you pay the first $100 of the dental care your receive for that plan year. After that, the insurance companies some of the cost and the remainder is typically covered by the copays or coinsurance fees you pay.

In Texas, deductibles varied, but within a relatively narrow range. The smallest deductible observed among the plans studied was $0. In fact, 20 percent of the plans examined had no deductible charge ($0). 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 $63 a year. Family deductibles were higher and often depended on the number of family members enrolled in the plan.

Teeth Whitening

Teeth whitening is a form of cosmetic dentistry and most plans do not cover cosmetic dental services. However, a review of 35 Texas plans found that 17 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

There are many businesses offering dental benefits for Texas residents. The 35 plans reviewed as part of this study came from the following nine insurance companies:

• Ameritas
• Careington
• Delta Dental
• Guardian Dental
• Humana Dental
• MetLife Dental
• Nationwide Dental
• NCD
• 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.