Regular dentist visits are vital to maintaining a healthy life, and ignoring this necessity can lead to serious health problems down the line. Delaying treatment only worsens the potential severity of conditions like gum disease and cavities, and the repercussions could affect other health outcomes.
According to Baily Insurance, people without dental benefits are 67% more likely to have heart disease, 50% more likely to have osteoporosis and 29% more likely to have diabetes.
Affordability is a significant barrier to getting dental care both in Texas and nationally. In anAmerican Dental Association survey, 61% of Texans cited cost as their main reason for avoiding the dentist, despite 84% understanding the need to visit the dentist twice annually and 97% agreeing that regular dentist visits keep them healthy.
That’s where dental insurance comes in. Many dental plans cover the full cost of biannual dentist visits and routine cleanings. More expensive procedures, such as fillings, root canals and crowns, are usually partially covered with coinsurance.
If you’re interested in purchasing individual or family coverage, you might be glad to know that prices are more affordable than you might think. This article will offer a look at the best dental insurance providers in Texas, the plans they offer, average premium and deductible costs, copays and coinsurance and more.
Key takeaways:
- Dental insurance works like standard health insurance, with a few crucial distinctions.
- Dental insurers typically pay 100% of the cost of in-network preventive care, 80% of basic services and 50% for major services.
- Benefits, coverage and premium and deductible prices vary depending on where you live, how old you are and what plan you choose.
- There are countless dental insurance options in Texas, but we’ve singled out the top four based on plan availability and variety, benefits/coverage, network size, cost-sharing models, average premiums and deductibles, waiting periods and other limitations.
- This roundup will cover the best dental insurance in Texas from Delta Dental, Independence American Insurance Company, Ameritas Life and UnitedHealthcare.
Like health insurance, private dental plans charge a monthly premium (around $50 on average) and an annual deductible. Many dental policies operate through a network-based coverage model, meaning customers can choose from a network of participating dentists or pay more for out-of-network care.
Dental plans place an annual coverage maximum on the amount they’ll pay for your coverage in a given year. When the maximum — typically $1,000–$2,000 — is reached, the customer must pay the full cost of their dental care.
Coveragewaiting periodsmay apply for dental work that goes beyond routine cleanings.
Coverage and coinsurance
Dental insurance plans usually use a 100/80/50 cost-sharing model, split into three tiers:
- 100% of preventive services and diagnostics:Routine cleanings and fluoride treatment, X-rays and testing for diseases or cancer
- 80% for basic procedures:Fillings, root canals, sealants and tooth extraction surgery
- 50% for major procedures:Crowns, bridges, implants and dentures
Coverage varies depending on the plan and insurance provider you choose.
Dental policies typically exclude cosmetic procedures such as teeth whitening and veneers. Some plans may cover orthodontic treatments partially through coinsurance.
Types of dental insurance
- Dental Preferred Provider Organization (DPPO)plans operate with a provider network, but you can see an out-of-network dentist at a higher cost. Most in-network preventive care is 100% covered.
- Dental Health Maintenance Organization (DHMO)plans usually don’t have a deductible or annual maximum, but you’ll be required to choose a primary care dentist from the provider network. Out-of-network coverage is typically not provided.
- Fee-for-Service or Indemnityplans don’t use a network, freeing up access to any dentist you want to see. These plans are often more expensive, and you’ll need to pay out-of-pocket until you meet the annual deductible.
Benefits and prices vary depending on your age and zip code. A quick search on theeHealth marketplacefor a 35-year-old non-smoking male in Dallas shows an array of options.
Monthly premiums range from $14.99 to $60 and maximum annual benefits range from $1,000 to $3,000 per person, with some plans having no annual maximum. The yearly deductible for individuals ranges from $0 to $150, but for most available plans, it spans $50 to $100.
While many dental insurance providers sell plans in Texas, we’ve chosen the top four based on an analysis of plan availability and variety, benefits, network size, average premium and deductible costs, waiting periods and other limitations.
Delta Dental Insurance Company
Delta Dental is one of the United State’s largest dental insurance providers, with more than 80 million customers in all 50 states, plus Puerto Rico and other U.S. territories.
The company has a national network of 39 subsidiary companies. In Texas, its plans are underwritten by Alpha Dental Programs, Inc.
Delta Dental offers basic and premium versions of its DPO offering — both include a network of 2,049 general dentists and no-cost cleanings. Teeth whitening, dentures and implant coverage are also available under some plans.
Delta Dental offers three plans for a 40-year-old person living in Austin. All require a $10 enrollment fee.
- Basic Delta Dental Individual DPO:$19.92 per month; 100% coverage for preventive care; fillings and extractions require a six-month waiting period; $50 annual deductible and $1,000 annual maximum
- Premium Delta Dental Individual DPO:$42.25 per month; 100% coverage for preventive care; fillings and teeth whitening require a six-month waiting period; root canals, crowns, dentures and implants coverage after 12 months; $50 annual deductible and $1,500 annual maximum
- DeltaCare USA TXA70 Individual and Family Program:$12.50 per month made in one $150 payment; no waiting periods, annual maximums or deductibles — however, there are copayments for most procedures; orthodontic services coverage; access to 78 primary care facilities
Independence American Insurance Company
Independence American Insurance Company is known for its specialty health insurance, including a lineup of PPO and indemnity dental products.
Both models offer similar rates and cost-sharing:
- Deductible: $50
- Maximum benefit: $1,000–$1,500
- Copayments: $0–$20
- Preventive care: 100% covered on the Indemnity plan; 80%–100% covered on the PPO plan
- Diagnostic services: 80%–100% covered
- Basic care: 50%–80% covered
- Major care: 50%
- No waiting period for preventive care
On the company’s website,the quote resultsfor a 50-year-old woman living in Houston show six options with deductibles priced at $50 per person and monthly premiums ranging from $22.72 to $41.35.
Ameritas Life
Founded in 1887 and selling dental plans since 1959, Ameritas Life is a well-established industry player. The company provides dental and vision plans toover 8 million people nationwide.
Ameritas boasts that its dental network is one of the largest in the United States, and participating providers offer 25%–50% savings on out-of-pocket costs.
Most Ameritas dental plans offer next-day coverage. All plans have no enrollment fees and cover 100% of in-network preventive visits.
Based on a search on the Ameritas website, someone living in San Antonio has the following dental-only insurance options:
- PrimeStar Protect Network 2000:$38.38 monthly premium; $50 deductible; $2,000 maximum annual benefit; 100-80-50 cost-sharing for preventive, basic, and major dental services; no waiting periods; works with a provider network
- PrimeStar Protect Network 1000:Same as above but with a $31.80 monthly premium and $1,000 maximum benefit
- PrimeStar Protect 2000:$56.68 monthly premium; $50 deductible; $2,000 maximum annual benefit; 100-80-50 cost-sharing for preventive, basic, and major services; no waiting periods; you can use out-of-network providers, but you’ll save money by staying in the network
- PrimeStar Protect 1000:Same as above but with a $45.28 monthly premium and a $1,000 maximum benefit
UnitedHealthcare
As theworld’s largest health insurer, UnitedHealth Group serves more than 40 million members across the United States. It offers a broad selection of dental plans with no age limit restrictions. Preventive care is covered with no deductible or waiting periods. Plans are underwritten by the Golden Rule Insurance Company.
A 27-year-old man living in Fort Worth, Texas, has 10 plan optionson the company’s website. Here’s a sampling:
- Essential Dental:$17.98/month estimated premium; $50 deductible; $1,000 annual maximum; $50 basic services deductible; preventive care 80% covered; basic services 50% covered after four-month waiting period; major services not covered
- Primary Plus Dental:$33.14/month estimated premium; $50 deductible; $1,000 annual maximum; no waiting periods; $50 basic services deductible; preventive care 100% covered; basic services 50% covered; major services not covered
- Premier Choice Dental:$42.04/month estimated premium; $50 deductible; $1,500 annual maximum; no waiting periods; $50 deductible for both basic and major services; preventive care 100% covered; basic services 50% covered; major services 10% covered; orthodontics not covered
- Premier Plus Dental:$48.89/month estimated premium; $50 deductible; $2,000 annual maximum; no waiting periods; $50 deductible for both basic and major services; preventive care 100% covered; basic services 35% covered; major services 10% covered; orthodontics 50% covered (a 12-month waiting period and $1,000 lifetime maximum applies)
TheNational Association of Dental Plansreports that around 80% of Americans have dental benefits, either through their employer, Medicaid, orMedicare AdvantageandMedicare Supplementplans. People who might be in the market for a private dental plan include:
- Independent contractors, business owners, and other people who don’t have a traditional employer
- People who are enrolled in an Affordable Care Act policy that comes without built-in dental benefits
- If you’re one of the37 million Medicare beneficiarieswho doesn’t have dental coverage
You can buy dental insurance from any one of the providers above. Do your own research and weigh your dental needs with your budget to find the best plan for you.
Alternatively, many dentists offer monthly payment plans or discount programs for uninsured patients. Some will even adjust their rates based on your income. Dental schools and community dental clinics are also an excellent option for low-cost dental care.
