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Dental Insurance Plans

Understanding dental insurance options, coverage types, and how to choose the best dental plan for your oral health needs and budget.

Dental Insurance Basics

Dental insurance helps cover the cost of oral health care, from routine cleanings to major procedures. Unlike medical insurance, dental plans typically have annual maximums and may have waiting periods for certain services.

What's Typically Covered

  • Preventive care (cleanings, X-rays)
  • Basic procedures (fillings, extractions)
  • Major services (crowns, bridges)
  • Orthodontia (varies by plan)

Key Limitations

  • Annual maximum benefits ($1,000-$2,500)
  • Waiting periods for major work
  • Pre-existing condition exclusions
  • Frequency limitations on services

Types of Dental Plans

Plan Type How It Works Pros Cons
Dental PPO See any dentist; pay less in-network Flexibility, no referrals needed Higher premiums, deductibles
Dental HMO Choose primary dentist from network Lower costs, no deductibles Limited network, need referrals
Indemnity See any dentist, plan pays percentage Maximum flexibility Most expensive, more paperwork
Discount Plans Not insurance; discounts at participating dentists Low cost, no waiting periods Not insurance, limited coverage

Understanding Coverage Levels

Most dental plans follow the "100-80-50" coverage structure:

Preventive Care

100%

Coverage

  • ✓ Cleanings (2x/year)
  • ✓ Exams
  • ✓ X-rays
  • ✓ Fluoride treatments

Basic Services

80%

Coverage

  • ✓ Fillings
  • ✓ Simple extractions
  • ✓ Root canals
  • ✓ Periodontal treatment

Major Services

50%

Coverage

  • ✓ Crowns
  • ✓ Bridges
  • ✓ Dentures
  • ✓ Implants (if covered)

Major Dental Insurance Carriers in California

Delta Dental

Largest dental network

PPO & HMO
Anthem

Anthem Dental

Complete coverage

PPO Plans
Blue Shield

Blue Shield Dental

Flexible options

PPO Network
Health Net

Health Net Dental

Affordable plans

HMO & PPO

Liberty Dental

Denti-Cal provider

Medi-Cal

Western Dental

In-house plans

Direct Care

Dental Plan Cost Comparison

Plan Feature HMO PPO Basic PPO Premium
Monthly Premium $15-25 $30-45 $50-75
Annual Deductible $0 $50-100 $25-50
Annual Maximum No maximum $1,000-1,500 $2,000-2,500
Cleaning Copay $0-10 $0 $0
Filling Copay $20-40 20% after deductible 20% after deductible
Crown Cost $200-400 50% after deductible 50% after deductible
Waiting Period None 6-12 months 6-12 months

Download Dental Plan Information:

How to Choose the Right Dental Plan

Consider These Factors:

Your Dental Health

  • Current dental problems?
  • Need for major work soon?
  • History of dental issues?
  • Preventive care only?

Your Preferences

  • Keep current dentist?
  • Need specialist access?
  • Budget constraints?
  • Orthodontia needs?

Quick Decision Guide:

Best Choice: Dental HMO or Basic PPO

Since preventive care is usually 100% covered, choose the lowest premium option that includes your preferred dentist.

Best Choice: PPO with high annual maximum

Look for plans with $2,000+ annual maximums and consider timing treatment across plan years to maximize benefits.

Best Choice: PPO or Indemnity plan

These plans allow you to see any dentist. Check if your dentist is in-network for better rates.

Best Choice: Plan with orthodontia coverage

Look for plans covering 50% of orthodontia with a lifetime maximum of $1,500-3,000. Some HMOs offer affordable orthodontia copays.

Denti-Cal (Medi-Cal Dental)

Denti-Cal is California's Medicaid dental program, providing free or low-cost dental services to eligible low-income individuals and families.

Covered Services

  • Exams and X-rays
  • Cleanings (every 6 months)
  • Fluoride treatments
  • Fillings and extractions
  • Emergency services
  • Root canals (front teeth)
  • Crowns (with approval)
  • Full and partial dentures

Who Qualifies?

  • Medi-Cal beneficiaries
  • Children under 21
  • Pregnant women
  • Adults 21+ (restored in 2022)
  • Income under 138% FPL

No Cost: Most services are free for Denti-Cal members

Denti-Cal Contact Information

Phone: 1-800-322-6384

Website: dental.dhcs.ca.gov

Ready to Find Your Perfect Dental Plan?

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