Health insurance plans cover doctor visits, drugs, hospitalization, etc but they exclude your teeth, gums, root canals, etc. You need Dental Insurance to cover your dental work and preventative care.
A Dental insurance plan will get you two cleanings per year, plus it will help to pay for more extensive dental procedures.
PPO vs. HMO Dental plans
PPO dental plans are widely accepted by dentists. You'll have a much easier time finding a dentist who "accepts" your dental insurance policy.
HMO dental plans cost less and offer more coverage (on paper) but it can be difficult finding a dentist who accepts DHMO plans. You find it difficult to get an appointment at an HMO dentist or you may find the dental clinic to be a bit factory-like and impersonal. Customers also frequently complain that HMO dentists routinely “up-sell” unnecessary procedures or attempt to charge more than the rates they are supposed to charge in the insurance contract.
If you have a particular dentist in mind or intend to find a good, highly-recommended dentist, a PPO dental insurance plan is usually the way to go.
If you need major dental work such as fillings, root canals, crowns, wisdom tooth removal, etc, you should know that PPO Dental plans have a "waiting period" before they'll cover major work. Typically, it is a 12-month waiting period.
However, there is one dental insurance company that has some calendar year plan designs, in which the waiting period ends and coverage increases on January 1st, so that means a shorter waiting period in most cases compared to other plans.
For that reason, and also because of the excellent network of dentists, I recommend these plans: https://myplan.ameritas.com/t/qbbbc.
This is also our recommendation for Dental Insurance that covers implants, which are usually excluded.
If you have a dentist that doesn't accept any insurance, (or says they only accept "Delta Dental" insurance) choose the “PrimeStar Advantage Plus 2000” plan for the best coverage (not the “Network” or “Progressive” plans).
The “Advantage Plus” plans plan offer you richer benefits out-of-network than the “Network” plan.
You’ll save money if you do stay within the network, because in-network providers have signed a contract to charge you lower rates. (The technical name of that lower fee schedule is “MAC/Maximum Allowable Charge”), but unlike plans from other companies such as Blue Shield and Anthem, you get the boosted “UCR/Usual, Customary, and Reasonable” fee schedule when you go to an out-of-network dentist. That gives you maximum freedom to choose your dentist.
Typical monthly cost:
$70 to $88 PrimeStar Advantage Plus
$16 PrimeStar Choice Vision
Or, if you’re willing to stick to the provider network and accept more limitations:
$39 to $55 PrimeStar Advantage Plus Network
$10 PrimeStar Select Vision
Recommended Dental Plans: https://myplan.ameritas.com/t/qbbbc
About the Delta Dental Premier network:
Many people have a dentist that will tell you that "we only take Delta Dental insurance."
A dentist's office who tells you this is usually talking about the Delta Dental Premier network, which is really very similar to the “UCR/Usual, Customary, and Reasonable” fee schedule described above.
You can obtain a Delta Dental Premier plan at the link below, however you may be better off with a “Advantage Plus” plans plan recommended above.
NOTE: Delta Dental has three different networks
- "DeltaCare" the HMO network
- the regular Delta "PPO" network
- the “Premier” network.
The “Premier” network is much larger. Delta Dental plans that do not have “Premier” in the name may not work with a dentist who has told you "we only take Delta Dental insurance."
You can click the provider search button to see which network your dentist participates in.
Call me at 626-765-4495 and I will help you enroll or answer questions. Again, I recommend the plans at: