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Routine dental visits support oral hygiene.1 The costs of visiting the dentist once or twice yearly can add up. Dental insurance can cover most out-of-pocket expenses even if you only visit the dentist once or twice yearly.
The American Dental Association (ADA) recommends visiting your dentist regularly to stay proactive. Certain diseases can manifest in the mouth and present signs, so early detection and treatment are crucial.2
Choosing the right dental insurance in California can minimize costs and help you receive the necessary treatment. It pays to review your dental insurance policy details, as the right one can save you hundreds of dollars or more.
Dental insurance companies classify plans into three categories:
Each plan type carries unique characteristics such as monthly or annual premium costs, typical coverage, and freedoms regarding which dentist you choose.
DHMO plans are sometimes called dental maintenance organization (DMO) or dental HMO plans. These dental coverage options work like standard health insurance.
The basic features of a DHMO plan include:
DHMO insurance plans work best for people who want affordable care and have an established relationship with a dentist within the approved network.
If you prefer to choose which dentist you’d like to go to, consider a PPO dental plan.
These plans include the following dental benefits:
The most significant differences between DHMO and PPO plans lie in the following:
PPO and DHMO dental insurance plans are the two main types of dental insurance you can choose from. However, you can also opt for discount plans that give you a break on total costs.
For immediate coverage, many people turn to dental discount plans. These offer an affordable alternative to true dental insurance for preventative care such as cleanings and X-rays.
Though dental benefits are less than with a PPO or DHMO plan, there are no claims to process or deductibles to calculate.
Delta Dental commands one of the largest dental networks nationwide. This insurance carrier offers both DHMO and PPO plans.3 Seniors can also access Delta Dental plans through AARP.
DHMO plans from Delta Dental fall under DeltaCare USA. Members receive lower rates with this type of dental plan, which requires you to visit a single in-network dentist.
If you prefer to work with a dentist, PPO dental plans grant you access to a broader network of approved dentists. You can also opt into Plus PPO plans to visit Premier dentists without paying higher fees.
Delta Dental also offers dental plans for immediate coverage. The No Wait and Immediate Coverage plans come without waiting period restrictions for basic preventative care.
This Delta Dental DHMO plan offers lower rates but requires members to visit dentists who are in the network.
Many find this dental plan best because it provides the following:
You may prefer Plus and Premier PPO Plans if you want to visit more than one dentist in a more extensive network. These plans are helpful if you plan on moving or enjoy the freedom of choosing which dentist you see regardless of your insurance coverage.
Delta Dental PPO plans include:
Plus PPO plans allow you to see Premier network dentists even if they aren’t in the network. Many people choose standard Delta Dental Premier PPO plans for lower out-of-pocket costs throughout the year.
Choose between the No Wait Plan and the Immediate Coverage Plan. Both plans waive the waiting periods for basic preventative care. The No Wait Plan has a $2,000 annual maximum benefit.
If you choose the Immediate Coverage Plan for orthodontic work, you must wait 12 months for this type of work. This plan also has a $3,000 annual maximum and a $1,500 lifetime maximum.
NCD 3000 and 5000 dental plans offer full coverage for major services without a waiting period.4 However, you must have previously had dental coverage to qualify for this benefit. If you haven’t had previous coverage, you’re subject to a 12-month waiting period.
Here are the basic elements of NCD dental insurance plans:
NCD dental plans typically have low deductibles and high annual maximums. However, they provide a wide range of preventative and basic care coverage. Many people choose NCD dental plans for their clear benefits and pricing structure.
Humana’s Extend dental insurance plans offer the best coverage for preventative services.5 The Extend 2500 and 5000 plans include:
Choose the Humana 2500 plan if you want a $2,500 annual maximum per person, with a $1,000 annual max per person for implants. The 5000 plan has a $5,000 annual maximum per person with up to $2,000 per year per person for implants. Each plan includes a $100 allowance for teeth whitening.
Humana also offers several other dental insurance plans, including a single DHMO and three PPO plans. Here’s a quick look at two of the most popular:
Each of the PPO plans includes free preventative care. Humana also offers special dental insurance plans for veterans and their family members. You can also save money by enrolling in dental and vision coverage.
People looking specifically for a PPO dental plan often choose Aetna Dental Direct.6 This plan waives waiting periods if you’ve had prior dental coverage. It also offers low rates and a wide range of dental providers.
Basic Aetna Dental Direct PPO plan features include:
Aetna also offers vision insurance to pair with your dental coverage. If you select Aetna through your employer, you can also choose a DMO plan at a lower cost. However, you must stick to one dental provider with this plan.
You must be an existing member of the Covered California health insurance company to add dental insurance to your health insurance coverage.7
You can find the following DHMO and PPO plans through the Covered California health exchange:
If you’ve already purchased health insurance coverage through Covered California, you can add dental coverage and save. This bundling opportunity can make Covered California health plans even more affordable.
Sorting through California dental insurance facts and figures can be stressful and confusing. Here’s a quick reference table to help you decide which dental insurance plan is best for you.
|Features||Delta Dental||NCD||Humana||Aetna||Covered California|
|Coverage Type||DHMO and PPO||DHMO and PPO||DHMO and PPO||DHMO and PPO||DHMO and PPO, but you must have Covered California health insurance already|
|Preventive Care||60 to100% covered||100% covered||80 to 100% covered||100% covered||100% covered|
|Basic Services||80 to 100% covered||80% covered||30 to 50% covered||Up to 80% covered||100% covered|
|Major Work||0 to 50% covered||50% covered||Varies by plan||Up to 80% covered||Varies|
|Deductibles||$0 to $50||$50 to $150||$0 to $150||$50 to $150||$0 to $65|
|Waiting Periods||Up to 12 months for major work, but otherwise, no waiting periods||No waiting period with prior coverage, but up to 12 months without||No waiting period with prior coverage||No waiting period for major work with prior coverage, otherwise, a 12-month waiting period||Up to a 6-month waiting period for major work but can shorten with proof of previous dental coverage|
|Orthodontic/Cosmetic Coverage||Immediate Coverage Plan and DeltaCare USA Plan||Some cosmetic but no orthodontic coverage||Does cover braces through the Dental Savings Plus discount plan8||Varies by plan||No coverage for adults, but children can receive medically necessary orthodontic care|
|Child/Family Care||Discounts for families||Discounts for families||Discounts for families||Discounts for families||Discounts for families|
The average monthly cost of dental insurance is between $15 and $85, depending on which plan you choose.9 Other factors, such as deductibles, annual maximums, and lifetime maximums, vary.
You can offset the cost of dental work with flexible spending accounts (FSAs) or health savings accounts (HSAs). Discount plans can also alleviate the financial burden of dental visits, though actual prices vary based on which dental plan you choose.
You should carefully review dental insurance policies to confirm what services are covered and where coverage gaps exist. Individual and family dental insurance plans that cover the most common costs can be well worth the monthly premium. Full coverage for more extensive procedures can also reduce how much you pay for dental services.
Here are some basic dental insurance terms you’ll come across:
Dental insurance is not mandatory in California. Dental insurance can provide several advantages and disadvantages, including the following:
Dental insurance plans vary depending on what you or your family need.
Here are a few tips to help you select the best dental plan that saves you money when you receive the necessary services:
Finding the perfect dental health plan can be difficult. You may often choose a plan that saves you the most money in one area versus across the plan itself. It all boils down to what dental care you need and when.
Choosing the right dental insurance plan in California can help cover basic dental treatment costs and save money. Getting the most value from your dental insurance plan requires selecting the coverage you’ll use.
From basic preventative care to emergency dental visits, California's best dental insurance plans reduce your financial contributions.
If you’re looking for new dental insurance in California, consider the plans we’ve discussed above. DHMO dental care plans can help if you haven’t selected a dentist yet but may need specialized care.
PPO plans make it easy to choose your dentist and still benefit from fully covered preventive services. Remember this as you search for the best dental insurance in California.
Some California health insurance companies provide dental coverage if you bundle your insurance plans. California dental insurance plans commonly pair with vision insurance as well.
Dental insurance can cost less than $20 per month or up to $100 per month. Comprehensive plans tend to have a higher monthly premium but can offer more valuable benefits.
Yes, Medi-Cal provides pediatric and adult dental insurance coverage.10 Benefits include coverage for preventative and restorative services.
Most California dental plans cover all or at least part of preventative treatment, such as bi-annual exams, X-rays, and fluoride treatments. Check your plan details to learn more about the services covered.
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