If you’re one of Virginia’s eight and a half million residents, you have the benefit of thousands of general and specialty dental practices. Virginians receive their dental coverage from a variety of sources ranging from privately purchased plans to employer plans to government insurance in the form of Medicaid or Medicare. This article reviews DentalInsurance.com’s latest research on the Virginia dental insurance market, including information on:
To provide some meaningful guidance to shoppers, DentalInsurance.com reviewed over two dozen dental plans offered in the State of Virginia. Price quotes were obtained for a hypothetical applicant who was 33 years old. The average monthly premium was $39.72 across all options (which included indemnity plans and a dental discount card alongside traditional PPO and HMO insurance), which is slightly more expensive than the average found for our 2022 study. The least expensive option was the dental discount card offered by Careington (Careington 500 Series Dental Savings). It had a monthly fee of $8.95. Among traditional dental insurance, a HMO dental plan was the least expensive. Dominion National Select Plan Basic charged only $13.51 a month for coverage (note that dental plan premiums can vary by region in a state). The least expensive PPO dental plan Ameritas’ Hollywood Smile Premier 1500, which had a monthly premium of $18.71.
At the other end of the price range, the most expensive option among the reviewed plans was Classic 2000 + VSP Premium from Nationwide. This was the only indemnity plan among the two dozen plans in the study. An indemnity plan does not restrict its enrollees to a dental network. This specific indemnity plan also adds vision benefits alongside its dental benefits. This plan cost $90.06 a month for the applicant details we provided.
The limit on insurer spending during a plan year, called the "maximum benefit," varied considerably among the dental plans under examination. Among the PPO and indemnity plans that did have a maximum benefit, the average annual limit in the first year of coverage was $1,771. In a few cases, the maximum benefit was increased across multiple years of enrollment. The plan with the highest maximum benefit was NCD Nationwide 5000 Plan with a $5,000 annual limit. The lowest limit, tied among several plans, was $1,000.
Neither dental HMO plans nor dental discount programs had a maximum spending limit on spending for dental care.
Even with dental coverage, a consumer should expect to pay out-of-pocket costs for dental care. Out-of-pocket expenses include deductibles, copayments, and coinsurance fees. For the 24 Virginia dental plans examined in 2023, the average deductible for an individual was $65.48 per year. Fillings were covered at an average of 60 percent of the total cost, with the remaining 40 percent being the responsibility of the enrollee (HMO plans, in contrast, charged a fixed copayment amount rather than covering a percentage of the cost). This 60 percent average represents a slight improvement in cost-sharing as compared to the average for 2022 (59 percent). Root canals and crowns had lower contributions from insurance companies at 37 percent of the total cost, though over a third of the plans increased their contributions for customers who stayed enrolled for a second and third year of continuous coverage. One Virginia plan, Anthem BlueCross BlueShield's Essential Choice Bronze, did not have any coverage for crown or root canal procedures, though Anthem's other plans in the study (such as the Essential Choice Gold and the Essential Choice Incentive) did cover these treatments.
Individual dental insurance refers to a dental policy purchased by a single individual. This type of dental coverage is contrasted to group dental insurance where an employer, union, or other organization purchases a dental policy to cover many people belonging to the organization. The state of Virginia has many insurance companies who offer dental coverage within the individual dental insurance market. Examples include Humana, Ameritas, MetLife, Nationwide, Renaissance, and Anthem BlueCross BlueShield.
Family dental insurance is distinguished from individual and group dental insurance by the following:
When applying for family insurance, an insurer requires that the applicant provide information (e.g. date of birth) on each family member who will be covered by the plan. Deductibles are normally higher for family coverage. Some plans charge a deductible (e.g. $50) per family member on the plan. In come cases, the maximum deductible a family can pay is capped (e.g. $150).
With the information provided in this study, you can compare your local rates to larger state trends. The following link will get dental insurance quotes for plans available in your zip code. You can also review the bestsellers below, which are the top-selling Virginia dental plans on DentalInsurance.com.
No waiting periods. Increasing benefits. Get the most out of this plan by using one of our 115,000
network providers.
Plan type: PPO
Plan Maximum: $1500
100% preventive coverage on day one. $2000 plan maximum. No waiting periods.
Plan type: PPO
Plan Maximum: $2000
Designed for people who are looking to maintain their oral health through regular dental exams and
cleanings
Plan type: PPO
Plan Maximum: $1000
This page sponsored by Teeth Wisdom contains links to Virginia-oriented websites on oral health and where to find affordable providers of dental care.
Begun in 1870 as the Virginia State Dental Association, the VDA has grown from its original nine members one hundred and fifty years ago to thousands today. The VDA has multiple objectives spanning dental professional advocacy to promoting best practices within the field of dentistry and providing professional development/continuing education to its members.
This page hosted by the State of Virginia provides consumers with resources to look up information on dentists (e.g. licensure), find COVID information regarding dental care, as well as file a complaint.
This resource from the Virginia Dental Association lists free and low cost dental options in the state. They include The VDA Foundation, Missions of Mercy, and donated dental services.
Sic semper tyrannis (Thus always to tyrants)
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