Table of Contents
Written By: Laura Larimer
Page Reviewed / Updated – 6/30/2022
Dental Insurance Quick Facts
  • Proper dental care is important for overall health, but an estimated 74 million Americans do not have dental insurance
  • PPOs are the most common type of dental insurance available
  • Original Medicare typically does not cover dental care, but some Medicare Advantage plans include coverage
  • Medicaid coverage of dental care varies by state

Despite its importance for overall health, dental wellness gets less attention than it should. Dental coverage isn’t considered “essential” for adults under the Affordable Care Act (ACA) health plan regulations, so those who want dental coverage often need to find it outside of their primary insurance. Without help from Medicare or Medicaid, seniors may feel lost when trying to find a privately offered dental plan that meets their needs.  

While dental care should be a high priority for everyone, many people report putting it off due to a lack of insurance and high costs. It’s estimated that about 74 million Americans do not have dental insurance, and high out-of-pocket costs prevent them from seeking regular care. Dental care is often the first of all medical services to be neglected, with 39% of adults reporting they have delayed services in the past year due to cost. Having a dental insurance plan can provide financial help and incentivize patients to visit a dentist on a regular basis.

Currently, of all the dental plan types available, Dental Preferred Provider Organizations (DPPOs, or just PPOs) are the most common. Other options include indemnity plans, which are quite similar to PPOs, and Dental Health Maintenance Organizations (DHMOs or just HMOs), which are less expensive but more restrictive in terms of which dentists patients can see. With so many options available, seniors may feel overwhelmed when trying to select a dental insurance plan. This guide will help take the confusion out of shopping for these plans. We researched PPOs and other coverage options offered by industry leaders, ranking them according to several metrics related to cost, coverage levels, and more. 

With so many options available, seniors may feel overwhelmed when trying to select a dental insurance plan. We researched PPOs and other coverage options offered by industry leaders, ranking them according to several metrics related to cost, coverage levels, and more. This guide will take the confusion out of shopping for a dental insurance plan by breaking down each company’s offerings, weighing the financial options, and providing answers to frequently asked questions.

The Best Dental Insurance of 2022

  1. MetLife: 5.0
  2. Humana: 4.6
  3. Cigna: 4.1
  4. Guardian: 3.6
  5. Aetna: 2.6
  6. Renaissance: 2.4
  7. Surebridge: 2.1

An Overview of Our Ranking Methodology

In ranking the top dental insurance companies, it’s important to use consistent standards when making comparisons. Below you can see the core metrics that we used to evaluate each company. 

  • Company Reputation and Reliability (20%): Does this company have a stable financial history? Has it been profitable and well-rated by consumers and experts alike?
  • Plan Variety (10%): Does this company offer insurance plans structured as HMOs, PPOs, and Indemnity plans? How many plans does the company offer overall? Are loyalty plans and insurance bundling available? 
  • PPO Coverage Limitations (30%): What are the highest yearly maximum benefit amounts available for this company’s regular and loyalty PPO plans? What kind of waiting periods and waiting period waivers do plans have?
  • PPO Costs (30%): How expensive are this company’s lowest-cost PPO plans? What is the highest percentage of a patient’s dental costs that PPO plans from this company will cover?
  • Dental Insurance Alternatives (10%):  Does the company offer dental discount plans for those who want an alternative to traditional dental insurance? What are the terms of the dental discount plans that are offered?

The Top 7 Dental Insurance Companies in 2022

Company Overall Score (1-5 Scale) Company Reputation and Reliability Plan Variety PPO Coverage Limitations PPO Costs Dental Insurance Alternatives 
MetLife 5.0 6.67 4 8 10 8.35
Humana 4.6 3.34 10 10 5 10
Cigna 4.1 10 0 4 8 5
Guardian 3.6 8.34 8 0 8 3.34
Aetna 2.6 5 2 2 4 1.67
Renaissance 2.4 1.67 6 2 2 6.68
Surebridge 2.1 0 6 5 0 0
Did you know?

Dental PPOs divide dental services into three categories: preventive, basic, and major. Other names, like I, II, and III, may be used to refer to the same categories.

  • Preventative services usually include two yearly cleanings/exams plus some form of coverage for x-rays (may be labeled diagnostic).
  • Basic services often include things like deep cleanings (for teeth that are in very bad shape), fillings, simple extractions, root canals (sometimes), and treatments for gum disease.
  • Major services usually includes procedures like bridges, crowns, root canals (if not considered basic), and other high-cost services, including sometimes dentures and implants.

Many slight variations exist from company to company, so read plan documents carefully.

MetLife

MetLife ranked first overall, scoring 5/5 stars. Its best metric is PPO Costs, with the company earning first place with 10/10 points thanks to the availability of some plans with very low premiums and deductibles. This company performed well in most other metrics, earning third place in Company Reputation and Reliability and second place in both PPO Limitations and Insurance Alternatives. However, MetLife ranked in fourth place in Plan Variety due largely to its low number of plans and lack of specialty options like loyalty plans and bundles.

How MetLife Scored

Company Reputation and Reliability: 6.67/10

With 6.67/10 points, MetLife ranks in 3rd place. It is the only company with an A+ rating from AM Best, making it second only to Guardian (A++). It is 3rd best in the Fortune 500 ratings with a ranking of 46. Founded in 1868, this company is the 4th oldest company we reviewed. Its rating on Google 3.4/5 stars was 4th best. With only 34 reviews Google posted, it’s somewhat difficult to know if the Google rating is representative of customer opinion.

Plan Variety: 4/10

MetLife scored 4/10, ranking in 5th place. This is one of three companies that offers two plan types, as opposed to the four plans that just offer PPOs. MetLife has both PPOs and HMOs. Its overall number of plans, 3, was tied with Cigna, Surebridge, and Renaissance for 2nd place. The highest number of plans available is 4 from Guardian and Humana. MetLife struggles to keep up when it comes to specialty plans, offering neither a loyalty PPO nor a bundled benefit plan.

PPO Limitations: 8/10

MetLife scored 8/10 points in PPO Limitations for 2nd place in this metric. MetLife’s highest yearly maximum for first-year coverage is an impressive $2,000- a full $500 higher than its nearest competitor aside from Surebridge who also offers $2,000. However, MetLife does not have a loyalty plan. This company’s waiting periods are average- 6 months for basic services and 12 months for major services. You may be able to skip the waiting periods if you have had “comparable dental coverage” for 12 months or more and can prove that you are currently covered.

PPO Costs: 10/10

In 1st place with 10/10, MetLife performed best in this metric. Across MetLife plans, patients pay 0% for preventive care and 50% for major services if major services are covered. Coverage levels for basic services vary, but patients pay as little as 50% on the highest coverage plan. While $50 deductibles are by far the most common in the industry, MetLife has a deductible of just $25 on its PPO-High plan. PPO-Medium has a $50 deductible and PPO-Low has a $75 deductible. MetLife’s lowest sample quote was $17 per month, coming in as the lowest monthly quote of all companies we reviewed.

Insurance Alternatives: 8.35/10

Scoring 8.35/10 points, MetLife ranked 2nd on our list. The MetLife Discount Dental Program offers 5%-50% off dental procedures, depending on the item and office. The discount network of dentists is provided through Careington and may have 175,000+ participating locations, though MetLife itself does not advertise a number. Currently, the plan is not offered in Washington, Utah, or Vermont. Like plans from Renaissance and Humana, this plan includes discounts on non-dental items. In MetLife’s case, these perks include discounts on eye exams, frames, lenses, and LASIK procedures. MetLife’s discount program had the lowest cost on our list, with an annual premium of $211 for a single person. Customers can opt to pay monthly, quarterly, semiannually, or annually, and the cost is the same either way.

Quick Facts About MetLife 

  • Started: 1868
  • Headquarters:  New York City, NY
  • Alternate Names and Related Companies: Individual plans from MetLife may be offered through “MetLife Takealong.” HMO plans from this company may be offered through MetLife Managed Care subsidiaries, but the company names vary by state. Dental Discount plans are offered in partnership with the third parties Careington International Corporation and VSP.

The MetLife Shopping Experience

MetLife is best known for its group (employment-based) benefits, so it keeps information on its individual plans on a separate website called the “MetLife Takealong” website. This brand is one of a few that does not ask about age when calculating premiums, so older seniors may have a slight price advantage. MetLife plans can also be found on some broker sites. This brand’s PPOs are generally available nationwide with very few exceptions, but its HMOs are available only in New York, California, Texas, and Florida.

Humana

Humana ranked highest overall with a score of 4.6/5 stars. This company was especially impressive in Plan Variety and PPO Limitations, ranking in 1st place for both. Humana also has a strong through not perfect score of 7/10 points in PPO costs, offering competitive premiums and coverage options. Humana ranked lower in other core metrics, and its lowest score was 2/10 on Insurance Alternatives due to limited options.

How Humana Scored

Company Reputation and Reliability: 3.34/10

Ranking in 5th place, Humana’s score was 3.34/10. Of the companies we reviewed, Humana had the best J.D. Power’s Dental Insurance Customer Satisfaction score with 793/1,000 (the highest company in that survey scored 810). Humana ranks at 41 on the Fortune 500 list and has 3.7/5 stars on Google reviews. Humana struggled the most with its AM Best score of A-, ranking the lowest on that submetric along with Surebridge. Its company history, although dating back to 1961, is also shorter than many competitors whose histories date back to the 1700 or 1800s.

Plan Variety: 10/10

Humana was 1st in Plan Variety with 10/10 points. Though no companies we reviewed offered all three main plan types (PPO, HMO, Indemnity), Humana was one of three companies that offered two types. Humana has both PPOs and HMOs. HMOs, in general, are rare now, and Humana’s are only offered in California, Florida, Maryland, Pennsylvania, Texas, Utah, New York, Nevada, and Guam. Among its four PPO options, Humana has a loyalty plan (Loyalty Plus PPO) and a plan that offers extra health discount benefits to veterans (Bright Plus for Veterans). In some cases, Humana dental plans can also be bundled at a low cost with vision or hearing benefits. Bundled plans may be easiest to find on broker sites.

PPO Limitations: 10/10

Humana ranked 1st with 10/10 points thanks to its great waiting period policies. Humana’s Bright Plus PPO has no waiting period for basic services, and its Loyalty Plus PPO has no waiting periods even for major dental work. Humana’s highest yearly maximum for the first year of coverage was $1,500. Its highest yearly maximum reachable in a loyalty plan was $1,000. For comparison, Surebridge’s loyalty maximum was $2,000, Renaissance’s $1,000, and all other companies lacked plans with increasing maximums.

PPO Costs: 5/10

Humana scored 5/10 points, ranking in 4th place. It has premiums starting at $19 per month, just $2 more than the lowest premium of $17 from MetLife. Humana’s coinsurance levels were typical on most plans, with customers paying 0% for preventive services, 30% for basic services, and 50% for major services on its highest coverage plans. Most of its deductibles are $50 per person each year, but its loyalty plan has an unusual lifetime $150 deductible instead. Keeping that plan for three or more years makes the high deductible more palatable.

Insurance Alternatives: 10/10

Humana scored 10/10 points in this category, ranking in 1st place ahead of all of its competitors. Humana’s Dental Discount Plus plan offers discounts averaging from 20%-40% with a network of over 335,000 dental locations. The plan includes discounts on some non-dental services, too. Unfortunately, the plan’s pricing is listed in a confusing way. Online, it seems the lowest annual cost for Humana’s dental coverage alternatives comes to $216 per year. Those interested in Humana’s discount plan should note that payments can only be made monthly and that it is currently not offered in 7 states.

Quick Facts About Humana 

  • Started: 1961
  • Headquarters: Louisville, KY  
  • Alternate Names and Related Companies: Humana Inc. has such a large number of subsidiaries that they are referred to collectively as “Humana Entities.” Names tend to vary by state. HumanaDental Insurance Company is a name you’re likely to see in reference to discount plans. A complete list of Humana Entities can be found on Humana’s own site.

The Humana Shopping Experience

You can shop for Humana plans through the Humana website itself or through some online insurance brokers. Quote tools on websites will generally ask you for your age and the state you live in, though some broker sites may ask for additional information. The information given on the plans through quote tools usually includes fine print on service limits and exclusions, which seniors should take into account when selecting a plan.

Seniors shopping Humana should be aware that this company’s plan availability varies greatly by state – more than is average for other companies. The majority of the states do have a dental discount plan, but 7 states do not, and the website simply lists the 43 states that do. Many states only have one or two plan options, though Humana’s full dental insurance product catalog includes 3 insurance options plus a dental discount plan.

Cigna

Scoring 4.1/5 overall, Cigna ranked in 3rd place for its dental plans. As a very well-established company in the industry, Cigna achieved 1st place for Company Reputation and Reliability. This company had a reasonably strong showing in PPO Costs and Insurance Alternatives, but it faltered in Plan Variety, where it came in last.

How Cigna Scored

Company Reputation and Reliability: 10/10

Cigna ranked in first place for Reputation and Reliability, scoring 10/10 points. Tracing its company roots to 1792, Cigna is the oldest company on our list. It’s also the most financially successful company, ranking number 13 on the Fortune 500 list. AM Best rates Cigna an A for financial stability, a score that puts the company in 3rd place for that submetric along with Aetna and Renaissance. JD Powers rates Cigna’s dental plans 787/1000, the 3rd best score among competitors that we reviewed. Cigna had 132 ratings on Google with an overall rating of 4/5 stars- the best on our list.

Plan Variety: 0/10

Cigna’s plan variety is quite limited, so this company ranked in last place with 0/10 points. Cigna offers just PPO dental and has 3 plan options total. Cigna has neither bundling options nor loyalty plans. Its plans still offer good coverage choices for many people, but it just doesn’t present the same range available elsewhere.

PPO Limitations: 4/10

With 4/10 points, Cigna ranked in 4th place for PPO Limitations. Its annual maximum is a generous $1,500, the 2nd highest of the companies we reviewed. Unfortunately, none of Cigna’s plans have the increasing yearly maximums that some people like in loyalty plans. Waiting periods in Cigna plans are standard- 6 months for basic services and 12 months for major services. Cigna does offer a waiver on waiting periods in some circumstances. You’ll need to have been covered for a full year by another plan if you want to qualify for the waiver, and other restrictions may apply.

PPO Costs: 8/10

Cigna ranked tied in 2nd place with 8/10 points for PPO Costs. This company’s main pricing issue is that it does not offer plans through broker sites, and its own quote tool makes it somewhat difficult to get a personalized quote. Cigna’s starting costs are prominently listed as being $21. The way Cigna advertises its prices was something we found unnecessarily confusing. Cigna’s deductibles are a reasonable $50, and its coverage rates are comparable to other companies. Patients pay 0% for preventive care across the board and can pay as low as 20% for basic and 50% for major services, depending on the plan.

Insurance Alternatives: 5/10

Cigna scored 5/10 points for Insurance Alternatives, ranking in 4th place. Its “Dental Savings Program” excludes an unusually large number of states, including the following: Alaska, California, Montana, North Dakota, Oklahoma, Rhode Island, South Dakota, Utah, Vermont, and Washington. In covered states, seniors can choose from three different discount options. There’s a basic option that includes just dental discounts, or they can pay more for the “family” version that has expanded benefits on everything from prescriptions to recreational activities. Cigna offers three different discount options. The least expensive plan is available for $252 per year, in line with the costs of Guardian’s discount plans.

Quick Facts About Cigna

  • Started: 1792
  • Headquarters:  Bloomfield, CT 
  • Alternate Names and Related Companies: Cigna’s full name is Cigna Health and Life Insurance Company. Cigna HealthCare of Arizona, Inc., Cigna HealthCare of Illinois, Inc., and Cigna HealthCare of North Carolina, Inc. are all subsidiaries.  

The Cigna Shopping Experience  

Cigna is one of the more difficult companies to shop online. Its quote tool makes it appear as if those who are interested in learning more about costs need to provide contact information and wait to be contacted by an agent. This is actually not true – seniors can leave contact fields blank and still see a personalized quote. Be aware that Cigna quotes are not available on broker websites. Despite the difficulties with getting quotes from Cigna, customers may appreciate how much educational material Cigna provides online about dental insurance.

Guardian

Ranking in 4th place overall, Guardian scored 3.6/5 points. This company’s best metric was Company Reputation and Reliability, in which it stands out as the only company with a perfect financial stability rating from AM Best. Guardian is also notable for its ranking of 2nd place in Plan Variety as 1 of only 3 companies we reviewed that offers a low-cost HMO option. This company ranked last for PPO Limitations, but 2nd place for PPO Costs.

How Guardian Scored

Company Reputation and Reliability: 8.34/10

With 8.34/10 points, Guardian has the best Company Reputation and Reliability. It’s remarkable as the only reviewed company rated A++ by AM Best. Other companies we reviewed had ratings of A- to A+. Founded in 1860, Guardian is the 3rd oldest company we reviewed and has 160+ years of experience in insurance. While it doesn’t have the largest revenue among competitors, Guardian does rank as number 227 on the Fortune 500 list. This company has a respectable rating of 746/1,000 from the JD Powers survey, and it has a great Google profile rating of 3.8/5 stars (based on 35 posted ratings).

Plan Variety: 8/10

Guardian scored 8/10 points, ranking in 2nd place. Offering both PPOs and HMOs, Guardian offers slightly more consumer choice than the four companies that only sell PPOs. However, Guardian’s HMO coverage is limited to California, Texas, New Jersey, New York, Ohio, Florida, Colorado, Illinois, Indiana, Michigan, and Missouri. Between PPOs and the HMO, Guardian offers 4 plans, of which one is a loyalty plan. Unfortunately, Guardian does not offer a clear bundling option for combining dental with vision, hearing, or other supplemental benefits. Customers may wish to ask a sales agent about the possibility of getting vision coverage since Guardian does sell some items separately.

PPO Limitations: 0/10

With 0/10 points, Guardian ranks last in this metric. Its low score is due mainly to no waiver option for waiting periods. Guardian’s highest yearly maximum benefit is $1,500, on par with Cigna. Its loyalty maximum is low at $1,500, compared to a high of $3,000 from Renaissance. Guardian has waiting periods of 6 months for basic services and 12 months for major services.

PPO Costs: 8/10

Guardian comes in third, tied with Cigna, scoring 8/10 points. This company’s lowest sample quote was identical to Cigna’s at $21, closely compared to similar plans that start around $19 elsewhere. Patients face standard costs for preventive (owing 0%), basic (owing 20%), and major services (paying as low as 50%). At most other companies, the patients can pay as low as 20% for the same service category. Guardian’s deductible is $50.

Insurance Alternatives: 3.34/10

Only better than Surebridge, Guardian earned 3.34/10 points and ranked in 5th place in this category. Guardian offers 4 alternative dental discounts, costing $252 annually. Only a monthly payment option is available.

Quick Facts About Guardian

  • Started: 1860
  • Headquarters: New York City, NY 
  • Alternate Names and Related Companies: Guardian’s full name is The Guardian Life Insurance Company of New York, New York. Guardian Direct is the subsidiary that individual plans may be offered or underwritten by. 

The Guardian Shopping Experience

Guardian has recently changed its website, and those trying to shop online may occasionally encounter glitches associated with the changes. Overall, the way this brand’s website works can be confusing. The Guardian Direct (individual insurance) quote tool asks for contact information, but it is possible to get a quote from the tool without providing that information if doing so makes you uncomfortable. For those having trouble with the website, calling Guardian is always a good option to get help, and quotes are also readily available at some broker sites. Note that this company’s PPOs are available in about 45 states, and its HMOs are available in just 11 states.

Aetna

In 5th place overall, Aetna scored 3.4/5 stars. As the best overall option for Insurance Alternatives, Aetna suits those seeking a low-cost dental discount plan. This brand also has a strong presence in both PPO Costs and Reputation and Reliability, earning 4th place in both of those metrics. Aetna’s overall score was reduced due to limited plan variety and low maximum benefit amounts.  

How Aetna Scored

Company Reputation and Reliability: 5/10

Landing in 4th place, Aetna scored 5/10 points. With a company history dating back to 1853, Aetna has the 2nd longest amount of experience in the industry. Its JD Powers’ score is also 2nd best at 791/1,000, topped only by Humana among reviewed companies. Aetna’s rating of A in financial stability from AM Best is lackluster when compared to Guardian’s A++. Aetna did not rank in the Fortune 500 list, and its 2.6/5 stars on Google reviews ranked in 5th out of 7 places in that submetric. Aetna’s Google profile score is based on 67 reviews.

Plan Variety: 2/10

With a Plan Variety score of 2/10, Aetna keeps its plan selection simple, ranking in 6th place. This company’s only dental insurance style is PPOs, and it only offers 3 plans (Preventive, Core, and Preferred). While many competitors offer loyalty plans with benefits that increase over time, Aetna does not. It does, however, offer some insurance bundling options. Adding vision benefits to your Aetna dental plan is very easy.

PPO Limitations: 2/10

Tied with Renaissance in 6th place for PPO Limits, Aetna scored 2/10 points. Aetna’s waiting periods are standard- 6 months for basic services and 12 months for major services. Waiting periods can be waived, too, as long as those applying to the plan had dental insurance within the 90 days prior to applying for an Aetna plan. Aetna struggles to compete with other companies with its annual maximums. The highest maximum this company offers is $1,250, which is 3rd best and lower than the $1,500 or even $2,000 maximums of some competitors. Aetna also does not offer any maximums that increase with time (loyalty maximums).

PPO Costs: 4/10

Aetna has mid-range PPO costs, sitting at 5th place in this metric with 4/10 points. Premiums from this brand start at $22, and deductibles are the industry standard of $50. Likewise, the best coinsurance levels from this company are in line with what’s most common among competitors. On Aetna plans, patients pay 0% for preventive services, as low as 20% for basic services, and 50% for major services. Though not exceptional in any price submetric, Aetna’s overall price structure is reasonable and predictable.

Insurance Alternatives: 1.67/10

In Insurance Alternatives, Aetna is the lowest of our reviewed companies with 1.67/10. Aetna has two dental discount plans, called Vital Savings and Dental Plus RX. These plans are available for purchase on a monthly basis. In a year, the total cost is $354 and is on the high side compared to its competitors. The main dental discount plan is available everywhere but in Montana and Vermont, and the prescription drug discount add-on may be slightly more limited. Seniors should note that Aetna advertises its discount levels as being between 15%-50% for many procedures.

Quick Facts About Aetna

  • Started: 1853
  • Headquarters: Hartford, CT  
  • Alternate Names and Related Companies: Other names for Aetna include Aetna Life Insurance Company and Aetna Dental Direct. Certain parts of Aetna’s dental plans may operate with assistance from the third-party companies First American Administrators, Inc. and/or EyeMed Vision Care LLC. Customers should note that CVS Pharmacy acquired Aetna in 2018. 

The Aetna Shopping Experience 

Aetna offers its plans on its own website, and its quote tool is a bit challenging to use. It will ask for your full name and several other personal details. However, you don’t actually need to provide contact information in order to see prices, so you don’t need to worry about being cold-called. Aetna plans have good national availability, though a few states may be excluded. Seniors should be aware that Aetna quotes are often not available through popular insurance broker sites- shopping on Aetna’s own website or contacting a licensed agent is your best shopping option.

Renaissance

Renaissance scored 2.4/5 stars overall, ranking in 6th place. This brand’s strengths showed up well in two different metrics: Plan Variety (3rd best) and Insurance Alternatives (2nd best). With high starting costs, complex coverage rules, and some mediocre customer ratings, Renaissance ranked 6th in PPO Costs and Company Reputation and Reliability.

How Renaissance Scored

Company Reputation and Reliability: 1.67/10

Renaissance scored 1.67/10, ranking in 6th place for this metric. While its company history stretches back 63+ years, it just doesn’t have as much experience as companies that were founded in the 1700s and 1800s. Its financial stability rating of A from AM Best and its customer rating of 2.2 on its Google profile was lackluster since some companies scored A++ and 4+/5 Google stars. Renaissance was not included in the JD Powers’ survey, nor does it have a high enough revenue to rank on the Fortune 500 list.

Plan Variety: 6/10

Renaissance scored 6/10 points and ranked in 3rd place for Plan Variety, tied with Surebridge. While Renaissance only offers one plan type, PPOs, it has 3 different PPOs to choose from. Some of the plans include bundled vision benefits and have coverage levels that increase over time (loyalty benefits). These special plans are part of the “Max” PPO product series.

PPO Limitations: 2/10

With 2/10 points, Renaissance ranked in 6th place in front of Guardian in PPO limitations. Renaissance’s most notable weakness in this metric is that it does not waive waiting periods for any reason. Plans in the “Max” series of bundled plans don’t have waiting periods, so in some cases, the lack of waiver is a moot point. However, the company’s lower coverage plans have 6-month waiting periods for basic coverage and 12-month waiting periods for major services. Renaissance’s yearly maximums are a mixed bag: loyalty plan maximums can reach $3,000, the best of all the companies, but non-loyalty plans are capped at a low $1,2000.

PPO Costs: 2/10

Renaissance ranked poorly in the PPO costs category, scoring 2/10 points. One factor that reduced Renaissance’s score is that its overall cost-sharing structure was less clear than that of other companies. Patients may need to pay as much as 50% for preventive services on some plans (compared to 0% everywhere else). Basic services can cost patients between 20%-50% (percentage can vary by procedure) and 50% for major services. This company’s absolute lowest monthly premium is $31, or $14+ more than the lowest premium from MetLife. Deductibles for Renaissance are a reasonable $50.

Insurance Alternatives: 6.68/10

Renaissance’s dental discount plan is a competitive option that ranks in second place with 6.68/10 points. This plan is referred to as the Healthy Savings Card and is administered by the third-party company Careington. Dental discounts range from 20%-50% for most services. Costing $372 per year, this plan is one of the more expensive discount options. Yearly payments appear to be the only option for purchasing this plan. Although Renaissance only has one option for this kind of plan, the plan conveniently includes other benefits for vision, hearing, and a variety of other health discounts.

Quick Facts About Renaissance 

  • Started: 1957
  • Headquarters: Indianapolis, IN  
  • Alternate Names and Related Companies: Some plans offered by Renaissance are actually offered by an independent division called Renaissance Life & Health Insurance Company of New York. The Healthy Savings Card is administered by the third-party companies Careington International Corporation and VSP (a vision care network). 

The Renaissance Shopping Experience

You can shop Renaissance plans on the Renaissance website or through some broker sites. The Renaissance website offers the most complete range of plan options, but it can be a bit difficult to find what you’re looking for. The company’s series of basic plans are listed on a different part of the website than its bundled/loyalty plans are. Furthermore, to shop for its Healthy Savings Card you will need to call the number provided on the website. Applying directly online is not currently an option. Renaissance does not list any major location exclusions for its insurance, all though not all states will have the same number of available plans.

Surebridge

Overall, Surebridge scored 2.1/5 stars for 7th (and last) place. Surebridges scores were neither especially high nor especially low for Plan Variety and PPO Limitations. Unfortunately, in both Company Reputation and Reliability and Insurance Alternatives, Surebridge ranked in last place, falling behind the majority of competitors due to its newness on the market and its lack of alternative options.

How Surebridge Scored

Company Reputation and Reliability: 0/10

Surebridge ranked in 7th place with 0/10 points for reputation and reliability. In this case, a score of 0 means that, for each of the 5 relevant questions we asked about Reputation and Reliability, Surebridge’s answers were the least impressive. Founded in 2011, Surebridge has an AM Best rating of A- and a Google review rating of 1.9/5 stars. It was not rated in the JD Powers survey or ranked in the Fortune 500 list. The relative newness and smallness of this company make it difficult to evaluate its reliability. Its Google business profile’s low rating is based on 116 reviews.

Plan Variety: 6/10

Tied for 3rd place and scoring 6/10 points, Surebridge has limited variety but still offers some unusual choices. Offering only PPOs, Surebridge has no indemnity or HMO options. With 3 PPOs to choose from, Surebridge has the fewest plans overall, along with Aetna, Cigna, And Renaissance. The highest number of plans offered by any company is 4. Despite having few choices, Surebridge does offer a special loyalty plan that includes bundled hearing and vision benefits. This plan, the DVH PPO, is a great choice for those who want a flexible, high coverage option. Note that this loyalty plan doesn’t have increasing maximums, unlike most loyalty plans, but it does have increasing coverage percentages for a variety of dental services.

PPO Limitations: 5/10

Ranking in 3rd place with 5/10 points, Surebridge offers high annual maximums, typical waiting period lengths, and the option of a waiting period waiver for those who qualify. Its regular PPOs have between $1,200-$1,500 yearly maximums, and its bundled loyalty plan has an annual maximum option of up to $2,000. Customers should note that the loyalty maximum is a combined maximum that applies to the bundled vision and hearing benefits of that unique plan as well. Surebridge has no waiting period for basic dental services and a 9-month waiting period for major services. The 9-month period cannot be waived.

PPO Costs: 0/10

Surebridge ranked 7th, scoring 0/10 points in the cost category. Its PPO Basic plan, a low-coverage option, has a monthly premium of around $43, higher than any other competitor we reviewed. Surebridge has a $50 deductible on most plans, though on its DVH plan its deductible is $100 for combined dental, vision, and hearing benefits. On its fullest coverage plans, patients pay 20% for basic services and 50% for major services. Surebridge also charges 50% coinsurance on preventive care, matching Renaissance as the only two companies to do so.

Insurance Alternatives: 0/10

Surebridge offers three discount plans as alternatives to traditional insurance. The lowest annual cost for the alternatives, however, is $516. This is much higher than every other alternative plan we reviewed. Monthly payment plans are the only option for payment.

Quick Facts About Surebridge

  • Started: 2011
  • Headquarters: North Richland Hills, TX
  • Alternate Names and Related Companies: The Chesapeake Life Insurance Company underwrites Surebridge’s dental plans, and HealthMarkets is the parent company. 

The Surebridge Shopping Experience

Surebridge plans are readily available on both broker sites and through the Surebridge website, and plans are offered across the nation. The Surebridge website has a confusing format, so in some cases, seniors may find broker websites easier to navigate than the Surebridge site. Surebridge appears to affix the label “senior” to some of its PPO options without any real meaning in terms of plan/cost differences.

A Full Explanation of Our Metrics

Company Reputation and Reliability

It can be hard to have confidence in a company that’s very new, that’s struggling financially, or that’s not well-spoken of by other customers. We looked at a variety of data points in order to assess Company Reputation and Reliability, and this metric accounted for 20% of each brand’s overall score. 

  • Year Founded: What year was this company (or its parent company) founded? Does it have an extensive amount of experience in the insurance industry?
  • AM Best Rating: How does the insurance evaluator AM Best rate this company for financial stability? We did not consider companies that had a rating lower than A-. For more information on this rating scale, see this Guide to Best’s Financial Strength Ratings.
  • JD Powers Score: Were this company’s dental plans part of the latest JD Powers’ Dental Plan Customer Satisfaction Survey? If so, what is its score out of the 1,000 possible points?
  • Fortune 500 Rank: Does this company have a high enough revenue to merit a spot on the Fortune 500 list? If so, where does it rank compared to other dental insurance companies?
  • Google Stars: Does this company’s headquarters have a Google business profile that has been rated by customers? How many reviews are posted? What is the average rating on the 1-5 star scale?

Plan Variety

Accounting for 10% of each company score, the Plan Variety metric explores how much choice is available to consumers. Though this article as a whole emphasizes PPO plans, this metric focuses on which companies have something beyond a typical PPO to offer. 

  • Plan Type Diversity: Does this company just offer PPOs, or does it also offer indemnity and/or HMO options? No plans on our list offered all three, but half offered two out of three.
  • Overall Number of Plans: How many plans, from all plan types, does this company offer? Will a customer feel limited or will they feel they have good choices?
  • Loyalty Plans: Does this company offer a “loyalty” PPO? In loyalty plans, benefits rise slightly in year two and reach their highest level in year three. By year three, the maximum benefit amount might double, or the coverage for a category of care might jump 10%-30%+ from its first-year level.
  • Benefit Bundling Plans: Does the company advertise a “bundled” plan that offers vision, hearing, or other benefits in addition to dental care? We looked for bundles on both company websites and broker sites. We considered how easy it appeared to bundle a plan.

PPO Coverage Limitations

All PPOs place limits on coverage, but some are more restrictive than others. Since differences in coverage limits can dramatically impact patient costs, this metric was 30% of each company’s overall score.

  • Highest Yearly Maximum (Regular PPOs): What is the highest (best) yearly maximum that each company has? Yearly maximums are the cap that a company places on coverage. After the company has paid this much for covered dental care, it will pay no more until the next benefit year.
  • Highest Yearly Maximum Reachable In a Loyalty Plan: Loyalty plan maximums usually increase in the second and third years. What is the highest that a loyalty maximum can get in this company? Companies with no loyalty plan did not score.
  • Best Basic Services Waiting Period*: Most plans require a 6-month wait for basic services. Did any company offer a plan that had a shorter waiting period or no waiting period at all? 
  • Best Major Services Waiting Period*: A one-year wait for major services is common. Did any plans have shorter waiting periods or did any company have no waiting period?
  • Waiting Period Waiver*: Some companies waive waiting periods for people who have had comprehensive dental coverage in the recent past. Which companies had a waiting period waiver? How easy is it to qualify for a waiver?

*Note: The information for these submetrics applies to most states, but some states impose special restrictions on companies that can make waiting periods even shorter or non-existent. Check to see if your state has special insurance regulations.

PPO Costs

The cost of a plan can be measured both by its up-front costs like premiums and by the amount of cost-sharing that a patient will need to cover within the plan when getting care. In this metric, we also explored the ease with which seniors can get a quote. This metric accounted for 30% of overall points. 

  • Quote Tools*: Some companies are aggressive in asking for contact information prior to providing a personalized quote. How easy was it to get a quote without providing your phone or email? Did the company also offer quotes on broker sites?
  • Lowest Sample Quote: What was the monthly cost for the most affordable PPO for seniors? In most cases, the lowest cost plan from a company was its “preventive-only” plan.
  • Individual Deductible: What deductible will the patient need to pay before coverage begins each year? We looked at individual deductibles, not family deductibles. Some companies had different deductibles on different plans.
  • Worst Preventative Coinsurance: Most dental PPOs offer 100% coverage for preventive care (like cleanings, exams, and x-rays) twice per year. Did any company offer less robust coverage for preventive care?
  • Best Basic Coinsurance: What was the lowest percentage of care cost that the patient would be responsible to pay for receiving basic services? Typically the lowest possible was 20% (the company pays 80%). Note that the best level for basic services was usually found on mid to high coverage plans, so this submetric typically does not reflect any preventive-only plans that the brand has.
  • Best Major Coinsurance: What was the lowest percentage of care costs that a patient could expect to pay for major services? The lowest levels for major services were often found in a brand’s highest cost plan. The most common percentage was 50%.

*Note: When asked for personal information from quote tools, we used the following demographic details: female, age 65, non-smoking, living in Tallahassee, FL, seeking coverage for one adult with no spouse or dependents. Using the same information across companies generated comparable answers.

Insurance Alternatives

Not everyone wants traditional dental insurance.  We looked at how many companies offered dental discount plans, a low-cost alternative to insurance that can help people save money.  This metric made up 10% of the overall scores.

  • Number of Options: How many dental discount options did the company have? All companies had a few options, ranging from 2 to 4 choices.
  • Excluded Locations: Do companies offer their discount plans in all states or are some states excluded? Most companies stated their location exclusions very clearly in advertising materials.
  • Non-Dental Discounts/Perks: Did the discount plan include some “perks” such as discounts for non-dental items? Discounts on vision and hearing care were commonly offered, though not universal. A multipurpose plan can be helpful for some.
  • Lowest Annual Costs: How much would it cost to pay for a year of coverage? Some companies listed monthly costs, and others yearly. We converted to a consistent measure as needed. Costs fell between about $250-$500 annually.
  • Payment Schedules Offered: Does the company give the patient the option of paying either yearly or monthly, whichever is more convenient? Does the company offer a discounted price on annual payments?

Financial Assistance for Dental Insurance for Seniors on a Budget

Dental insurance may seem too expensive, but it’s more important than you may realize. Oral health can have a major impact on the rest of the body, and financial assistance to access dental care can be helpful in maintaining overall health.

Unfortunately, Medicare typically does not cover dental care, and less than half of states’ Medicaid programs offer any dental insurance coverage for older adults. But for those struggling to afford the costs of dental care, there are some alternatives to traditional dental insurance. Government programs, charitable organizations, and even credit card companies offer a way to cover some or all of the cost of dental procedures. 

Below are a few dental resources for seniors on a budget.

Medicare Coverage of Dental Insurance

Medicare does not typically cover dental procedures, except in extreme circumstances. When a dental emergency occurs and lands a patient in the hospital, Medicare will likely cover part or all of the procedures to repair the damage. However, regular checkups, fillings, root canals, crowns, and other common dental procedures are not covered.

While Medicare Part A will rarely cover dental work, Medicare Part C, also known as Medicare Advantage, can include dental coverage. These plans are managed by private insurers who can choose exactly what they will and won’t cover. Searching for a Medicare Advantage Plan that includes dental coverage can be a good way to help bring down the out-of-pocket expenses of senior dental care.

To get started, visit the Find A Medicare Plan tool on the Medicare website. You can create an account or continue without logging in. On the next page, choose “Medicare Advantage Plan” and enter your zip code. The system may request that you select your county, too. Finally, the tool will ask if you receive any other assistance for your medical bills. Select any programs you belong to, and click ‘continue.’

On the next page, the tool will ask if you want to see specific drug costs. If you have prescriptions, it’s a good idea to select ‘yes’ and add them to the list on the next page. If not, you can select ‘no’ and move on.

After moving to the final page, you’ll see a listing of Medicare Advantage plans. You can add a variety of filters to the search results by clicking the various options next to the words ‘filter by.’ If you filter by ‘plan benefits,’ you can then select ‘dental coverage.’ Now, you’ll be presented with a list of Medicare Part C (Medicare Advantage) plans that are available in your area and also provide dental coverage.

Medicaid Coverage of Dental Insurance

While Medicaid’s Children’s Health Insurance Program (CHIP) is required to offer dental care to kids, Medicaid is not required to offer any dental coverage to adults. Less than half the states in the US provide comprehensive dental coverage to adults on Medicaid. In these states, the coverage tends to be reserved for those with the greatest financial need.

According to the Center for Healthcare Strategies, Medicaid covers adult dental services on four different levels: no coverage, emergency coverage, limited coverage, and extensive coverage. Each state offers different services and different levels of cost. Below is a table detailing each state’s Medicaid dental coverage:

State Medicaid Coverage of Dental Care State Medicaid Website
Alabama None – No dental coverage available through Medicaid https://medicaid.alabama.gov/content/4.0_Programs/4.2_Medical_Services/4.2.2_Dental.aspx 
Alaska Emergency – Up to $1,150 per year for preventive dental care, and enhanced services offer preventive and restorative care. https://dhss.alaska.gov/dph/wcfh/Pages/oralhealth/faq.aspx 
Arizona Emergency – ALTCS members receive up to $1,000 in preventive care and up to $1,000 in emergency care. https://www.azahcccs.gov/Resources/Downloads/DFMSTraining/2018/DentalUpdates.pdf 
Arkansas Limited – Up to $500 per year for most dental care, as well as limited coverage for services deemed necessary by a dentist. https://humanservices.arkansas.gov/divisions-shared-services/medical-services/healthcare-programs/dental/ 
California Extensive – Up to $1,800 per year, plus additional coverage if dental work is seen as medically necessary. https://www.dhcs.ca.gov/services/Pages/MediCalDental.aspx 
Colorado Extensive – Up to $1,500 per year. https://hcpf.colorado.gov/dental-benefits 
Connecticut Extensive – Up to $1,000 per year. https://portal.ct.gov/HUSKY/The-Connecticut-Dental-Health-Partnership 
Delaware None – No dental coverage available through Medicaid https://www.dhss.delaware.gov/dhss//dmma/adult_dental_benefits.html 
District of Columbia Extensive – Coverage for children and adults, including 2 annual cleanings and restorative fillings. https://dc.gov/service/medicaid 
Florida  Emergency – Only emergency dental situations are eligible for coverage. https://ahca.myflorida.com/medicaid/Policy_and_Quality/Quality/clinical_quality_initiatives/oral_health/index.shtml 
Georgia Emergency – Only emergency room visits and life-threatening situations are eligible for dental coverage. https://dhs.georgia.gov/medicaid 
Hawaii Emergency – Adults can receive emergency care to control dental pain or infection. https://medquest.hawaii.gov/en/members-applicants/quest-integration-coverage/covered-services.html 
Idaho Extensive – Preventive, diagnostic, and therapeutic dental coverage for all adults. https://healthandwelfare.idaho.gov/providers/managed-care-providers/dental 
Illinois Extensive – A wide variety of services are covered for adults. See the link for a detailed fee schedule. https://www2.illinois.gov/hfs/MedicalProviders/MedicaidReimbursement/Pages/Dental.aspx 
Indiana Limited – HIP Basic doesn’t cover dental services, but HIP Plus offers dental and other services for a low, predictable monthly cost. https://www.in.gov/medicaid/ 
Iowa Extensive – Up to $1,000 per year of dental coverage. https://dhs.iowa.gov/ime/members/medicaid-a-to-z 
Kansas Limited – Dental care is available for children, while limited preventive care is available for adults. https://www.kdhe.ks.gov/183/KanCare-Medicaid 
Kentucky Limited – Adult coverage includes limited oral exams, emergencies, x-rays, extractions, and fillings. https://chfs.ky.gov/agencies/dms/dpo/bpb/Pages/dental.aspx 
Louisiana Limited – Adult coverage is limited but includes exams, x-rays, and dentures. https://ldh.la.gov/page/2067 
Maine Emergency – Coverage is limited to emergency surgery, extractions, pain relief, infection care, and services to avoid tooth loss. https://www.maine.gov/dhhs/oms/mainecare-options/adults 
Maryland None – No dental coverage available through Medicaid https://health.maryland.gov/mmcp/Pages/maryland-healthy-smiles-dental-program.aspx 
Massachusetts Extensive – Adults enrolled in MassHealth are eligible for dental coverage. https://www.mass.gov/info-details/learn-about-masshealth-dental-benefits 
Michigan Limited – Coverage includes limited checkups, cleanings, x-rays, fillings, extractions, and dentures. https://www.michigan.gov/mdhhs/assistance-programs/healthcare/help/type/free-or-low-cost-care-from-a-dentist 
Minnesota Limited – Only services deemed medically necessary and cost-effective. Evaluations, preventive care, and restorative care can be covered. Prior approval may be needed. https://mn.gov/dhs/medicaid-matters/oral-health/ 
Mississippi Limited – General dentistry, oral surgery, and orthodontia are covered. https://medicaid.ms.gov/medicaid-coverage/covered-services/ 
Missouri Limited – Services are only available for those in a category of assistance for pregnant women or the blind. https://health.mo.gov/living/families/oralhealth/low-cost.php 
Montana Extensive – Up to $1,125 of annual dental coverage. https://dphhs.mt.gov/MontanaHealthcarePrograms/Dental 
Nebraska Limited – Up to $750 of annual dental coverage. https://dhhs.ne.gov/Pages/Medicaid-Dental-Benefits-Manager.aspx 
Nevada Emergency – Dental exams and extractions in an emergency are covered, and sometimes dentures when necessary.  https://dhcfp.nv.gov/Pgms/CPT/Dental/ 
New Hampshire Emergency – Coverage for severe dental trauma. Plans are being implemented for preventive care for adults. https://www.dhhs.nh.gov/programs-services/medicaid 
New Jersey Extensive – Coverage includes 2 annual checkups, diagnostic services, restorative services, and oral surgery, among other benefits. https://www.nj.gov/humanservices/dmahs/boards/maac/MAAC_Meeting_Presentations_4_13_17.pdf 
New Mexico  Extensive – Dental coverage varies by dental provider. https://www.hsd.state.nm.us/lookingforinformation/dental-care-information/ 
New York Extensive – No spending limits for dental coverage. Care includes preventive, periodontal, dentures, and oral surgery.  https://www.macpac.gov/wp-content/uploads/2015/06/Medicaid-Coverage-of-Dental-Benefits-for-Adults.pdf 
North Carolina Extensive – No spending limits for dental coverage. Care includes preventive, periodontal, dentures, and oral surgery.  https://www.macpac.gov/wp-content/uploads/2015/06/Medicaid-Coverage-of-Dental-Benefits-for-Adults.pdf 
North Dakota Extensive – Coverage includes exams, x-rays, filling, surgery, cleanings, root canals, and other dental services. https://www.nd.gov/dhs/services/medicalserv/medicaid/covered.html 
Ohio Extensive – Coverage includes, cleanings, dentures, fillings, extractions, crowns, oral surgery, and root canals  https://medicaid.ohio.gov/families-and-individuals/srvcs/dental 
Oklahoma Emergency – Extractions in emergency situations are covered. https://oklahoma.gov/ohca/individuals/soonercare-dental.html 
Oregon Extensive – No details available. https://www.oregon.gov/oha/HSD/OHP/Pages/Policy-Dental.aspx 
Pennsylvania Limited – Emergencies and oral surgeries are covered, along with other services in specific circumstances. https://www.dhs.pa.gov/Services/Assistance/Pages/Dental-Services.aspx 
Rhode Island Extensive – Coverage includes 2 annual checkups, x-rays, root canals, restorative, and periodontal services, among others. https://eohhs.ri.gov/sites/g/files/xkgbur226/files/Portals/0/Uploads/Documents/Dental_Benefits_for_Adults_-2007.pdf 
South Carolina Limited – Up to $750 annually for 1 annual cleaning, oral exams, x-rays, extractions, and fillings. https://www.scdhhs.gov/press-release/healthy-connections-now-provides-adult-dental-benefits 
South Dakota  Limited – Up to $1,000 annually for 2 annual exams, 2 annual cleanings, fillings, x-rays, extractions, and more. https://dss.sd.gov/medicaid/recipients/dental.aspx 
Tennessee None – No dental coverage available through Medicaid https://www.tn.gov/tenncare/members-applicants/dental-services.html 
Texas Emergency – Only dental care needed in an emergency is covered by Medicaid. https://www.hhs.texas.gov/services/health/medicaid-chip/about-medicaid-chip/medicaid-medical-dental-policies 
Utah Emergency – Coverage is limited to emergency situations for non-pregnant adults. https://health.utah.gov/umb/benefits/medicaid/dental.php 
Vermont Limited – Up to $510.00 per year for non-cosmetic procedures. https://www.healthvermont.gov/wellness/oral-health/dental-care-and-insurance 
Virginia Emergency – Adult dental coverage is limited to emergencies only. https://www.dmas.virginia.gov/#/dentalservices 
Washington Extensive – Coverage includes exams, cleanings, x-rays, fillings, extractions, oral surgery, and more. https://www.hca.wa.gov/health-care-services-supports/apple-health-medicaid-coverage/dental-services#dental-services-for-adults 
West Virginia Emergency – Oral surgery is covered in emergency situations. Orthodontic services require prior authorization. https://dhhr.wv.gov/bms/Provider/LTC/Documents/Chapter%20505%20Dental,%20Orthodontics,%20and%20Oral%20Health%20Services.pdf 
Wisconsin Extensive – Coverage includes annual exams and cleanings, but does not cover orthodontia. https://www.dhs.wisconsin.gov/guide/freedental.htm 
Wyoming  Limited – Emergency and preventive care only. Restorative dental coverage is not available. https://health.wyo.gov/wp-content/uploads/2018/02/Dental-Services.pdf 

* Be sure to check your state’s Medicaid website for the latest updates. Detailed information on state-specific Medicaid dental coverage can be found here.

Veterans Resources for Dental Insurance

Veterans Affairs offers a wide array of dental services to veterans of the Armed Forces. In 2021, the organization provided dental care to over 500,000 veterans.

Qualifying for dental care through the VA can be complicated, however. Care is provided to certain groups based on a variety of factors, including:

  • Military branch
  • Length of services
  • Former POW status
  • Service-related disabilities
  • Specific wars of enlistment
  • Inpatient status (hospital, nursing home, etc)

Below is a table detailing dental coverage for specific classes of military veterans.

Class Situation Dental Coverage
I Experiencing service-related dental disability and receiving monthly compensation All needed dental care is covered
II Served 90+ days in the Persian Gulf War One-time dental care available if you didn’t receive a dishonorable discharge, applied for coverage within 180 days of discharge, and DD214 doesn’t show a complete dental exam and all needed treatment before discharge
IIA Experiencing a service-related, non-compensable dental issue, or a combat wound/service trauma disability All needed dental care required to ensure you keep a working set of teeth
IIB Member of Homeless Veterans Dental Program One-time dental care a VA provider deems necessary for pain relief, helping you get a job, or treating gingival or periodontal conditions
IIC Former POW All needed dental care is covered
III Experiencing a dental condition brought on by service-related health issues All dental care to treat oral conditions that the VA provider determines are making the service-related health condition worse
IV Unemployable and receiving 100% disability benefit due to service All needed dental care is covered, as long as the 100% disability rating is permanent 
V Active in Ch 31 Veterans Readiness & Employment Program All dental care a VA provider deems necessary for you to be in the employment program, reach the goals of the program, protect you from having to stop the program, help you get back to the program faster if you’ve stopped, help you get and adjust to a job, or make you fully independent in your living
VI Receiving VA care or about to enter inpatient care All dental care needed to treat the issue that a VA provider finds is making your inpatient condition harder to treat
Inpatient Receiving inpatient care All dental care needed that a VA provider and primary care physician deem necessary to help with your current inpatient condition

Homeless veterans also have financial options for dental care. The Homeless Veterans Dental Program is a separate dental program that specifically assists those dealing with homelessness or who are in the VA homelessness rehabilitation program.

Additional Financial Assistance Resources for Dental Insurance

In addition to the above resources for dental coverage and discounts, there are other paths to assistance for those who can’t afford dental care.

As mentioned earlier in this article, most dental insurance companies offer a non-insurance discount plan. Typically priced at $70 – $150 per year, these plans offer access to a network of dentists without dealing with waiting periods. Discounts tend to range from 5% – 60% off the retail price of a dental procedure.

Another option for covering dental costs is to search for pro bono work. These are situations where a dentist may provide low-cost or free dental services, commonly as a way to give back to the community. Dental schools will occasionally offer this type of work as a way for a student dentist to learn alongside an experienced dentist.

Below are a few more resources that can assist low-income seniors with their dental needs:

Resource Website How They Help
Dental Lifeline Network https://dentallifeline.org/  A charity that provides access to dental care for those who cannot afford it any other way. Beneficiaries must be 65 or older, medically fragile, or have a permanent disability.
Smiles for Everyone Foundation https://www.smilesforeveryone.org/  A charity that has donated over $20 million in oral care services since it began in 2011. It runs programs that offer free basic dental services, extensive dental procedures, and dental implants. All patients must apply and be accepted.
Charitable Smiles https://www.charitablesmiles.org/  A charity that matches those in need with dentists who will provide free dental care.
Care Credit https://www.carecredit.com/dentistry/  A credit card designed to cover out-of-pocket healthcare services. This card provides months-long financing options and zero interest on costs above $200. The card is accepted at 250,000 different healthcare locations in the US.

The Financial Impact of Dental Insurance

Within the insurance industry, there’s some debate about the value of offering individual dental plans to customers. While it’s undeniable that the strict coverage limits of dental plans can cause problems, plans are still beneficial for many — it all just depends on the plan and the person. Below you can learn about financial factors to consider.

Did you know?

PPO plans are very similar to indemnity plans, which are also called Fee-For-Service (FFS). In PPOs, you get the best level of coverage within a predetermined network of dentists, and in indemnity plans, you typically get the same coverage regardless of network. Both plan types may have a network of preferred providers available, however. In indemnity plans, you also may be more likely to be balance billed (see “Key Financial Concepts in Dental Billing”). Otherwise, these two plan types are virtually indistinguishable. Much of the information below about PPOs also applies to indemnity plans.

The Financial Risks and Benefits of Using a Dental PPO

The Risk: Losing Money or Breaking Even on Premiums

It’s entirely possible and even common for a patient to put more money into a plan than the plan ends up paying out in benefits. To consider this possibility, it’s helpful to look at some hypothetical numbers. Suppose you purchase a plan that has $30 monthly premiums, a $50 deductible, and a $1,000 coverage limit. It covers 100% of preventive services, 80% of basic services, and 50% of major services. For this plan, your yearly spending on premiums will be $360. Note that deductibles are not usually charged for preventive care.

Now imagine that the plan covers twice-annual preventive visits that together are worth $300. If you only end up needing preventive care in a year, then you would essentially lose $60. If you only took advantage of one of the two cleanings available to you, you would essentially be paying $360 for about $150 of dental care, a loss of $210. If the preventive care were worth slightly more than $300 total, then it’s likely you would break even on the plan, meaning you could have paid out of pocket with less hassle.

The Potential Benefit: Saving Money With a Dental PPO

For the same hypothetical plan above, if you use more than preventive care in a year, then the plan may provide a significant financial benefit. Suppose that during the course of one year you got the same $300 worth of preventive care, plus you needed $250 in services classified by the plan as “basic” and $1,000 for services classified as “major.” The table below shows the breakdown of what you and the plan pay.

Cost Sharing for the Hypothetical Plan*

You Pay Plan Pays
  • $360 for premiums
  • $50 for the deductible
  • $50 for your share of basic services (20%)
  • $500 for your share of major services (50%) 
  • $300 for preventive services (100%)
  • $200 for its share of basic services (80%)
  • $500 for its share of major services (50%)
 = $960 total costs to you = $1,000 total cost to insurance 

*Note: This hypothetical situation does not address some of the more complex cost issues that can arise when plans have extremely specific coverage exclusions. This example also assumes that the patient is receiving care in-network, where coverage will be the best. 

In such a scenario, you will have maxed out what the plan can provide to you for the year, but will have received $1,550 worth of care. In other words, you’ve paid for about 61% of your actual dental care costs, overall. 

Other Options: Alternative Plan Types to Consider 

As the above examples show, paying for a medium to high coverage PPO (or indemnity) plan is something of a gamble since you’ll likely lose a bit of money if you only end up needing preventive care. Moreover, most plans have waiting periods. If you can’t get a waiting period waiver, the plan might be less useful to you, depending on your situation.

If you still want a dental plan, but you think a high coverage option is unlikely to be a good deal for you, you can look into the following options instead.

Preventative-Only Plans
PPOs and indemnity plans are often available in preventive-only versions that are ideal for seniors who want a plan that incentivizes them to get regular checkups. These plans start at about $180 for a year, and if you utilize both preventive visits provided, you may save $100-$200 per year on that care. It all depends on the cost of care in your area and the exact terms of the plan, of course. Preventive plans usually don’t have waiting periods or annual maximums, but they cover few services. You’ll be paying for any fillings and other work out of pocket, though a small discount may be provided as a courtesy.

HMO Plans
These plans, which are structured completely differently from PPOs, often cost $8-12 a month. They are restrictive, limiting the patient to only visiting one local dentist. Seeing a specialist requires a referral. On these plans, you’ll pay for care based on a list of copays, many of which are quite low ($10, $20, or $50 in many cases) for the most commonly utilized services. There are also no waiting periods, deductibles, or annual maximums. HMOs are available in a few states, and patients may sometimes wait a while for appointments due to poor dentist-to-patient ratios in the network. Scrutinize the network and copay list to see if coverage is a good fit.

Discount Plans
Dental discount plans may cost you between about $70-$150+ in a year. These plans do not qualify as insurance. Instead, they merely offer patients access to a network of dentists that have agreed to treat patients at discounted levels. With no waiting periods, deductibles, or yearly maximums, they provide flexibility. They can offer discounts on services like teeth whitening or orthodontia that aren’t covered by most PPOs, too. You’ll have to pay for all of your own care out of pocket, but you may find that you save several hundreds of dollars a year through discounts ranging from about 5%-60%, depending on the plan. These plans can help manage costs for those who need major work right away. Always check the discount network carefully to make sure it includes the dentist(s) you want to visit.

The Financial Impact of Dental Exclusions for PPO Patients

Companies have the freedom to specify coverage exclusions that may render a plan unhelpful in situations when you need financial assistance the most. Exclusions are the reason you always need to read every page and paragraph of a plan’s “Schedule of Benefits” and other documents before signing up. Some limits, like the exclusion of cosmetic work and orthodontia for adults, may not matter to you at all. Others should give you pause, particularly if the plan’s premiums are high. Below you can explore examples of exclusions so you know what to look out for in plan documents.

Common Coverage Exclusions:

  • Total Exclusions: The plan may state that a certain category of work or a certain procedure/item is entirely excluded, with no exceptions.
  • Materials/Method Exclusions: If there is more than one way to treat a dental issue, the company may specify that it only covers the lower-cost option, regardless of what the dentist recommends.
  • Age-Based Limits: Some care is only covered for children. Typically if orthodontia coverage is advertised in a plan, the fine print indicates it’s unavailable to those over age 19.
  • Time Period Limits: The plan may cover a procedure like an implant, but it may specify that it only covers 1 implant per 5 years, regardless of your actual need (this is a real example from a popular plan). The exact number of times an item is covered per time period will vary.
  • Lifetime Maximums: Expensive dental items/services may be placed in their own coverage categories, and that category may have a special “lifetime limit” such as $1,000. This is especially common for dentures.
  • Pre-Existing Conditions Exclusions: Some plans state that they won’t cover issues that existed before coverage began. For example, if you got a crown in the past, but the crown breaks while you’re under the plan, the plan may refuse to cover its replacement since the problem began before coverage started. In such cases, even waiting period waivers cannot help your situation.

How Dental Offices and Insurance Companies Handle Insurance Claims

If you’re going to sign up for a PPO or an indemnity plan, it’s smart to learn how dental billing works for those plans. Although the information below is quite technical, it will help you fully understand your situation if, in the future, your plan refuses to pay the portion of a bill. This information is particularly important if you choose an indemnity plan or if you get a PPO but chose to use out-of-network providers. In both situations, balance billing, discussed below, might be an issue for you.

Key Financial Concepts in Dental Billing

Concept Definition and Context
Usual and Customary (UC) Charge This is the amount that the dental provider (dental office) always charges for a given service. 
Usual, Customary, and Reasonable (UCR) Charge  This is the maximum amount of money that the insurance company sees as a reasonable cost for a particular service. The insurance company commits to pay a certain percentage of the URC, and the patient is often liable for a percentage as well. 
Balance Billing  If the dental office’s UC is higher than the insurer’s URC, the dental office might bill the patient for the difference. 
Write-Offs and In-Network Providers Dentists that want to be considered in-network/preferred providers must sign contracts. Many network dentists have contracts in which they automatically discount the UC for patients who are on a particular plan. The contract may also forbid them from balance billing the insured patients. PPO plans usually forbid balance billing in their network, but indemnity plans, which allow greater freedom to choose providers, often allow it.
If balance billing is forbidden but the UC happens to be greater than the UCR, then the dentist cannot legally attempt to make anyone pay the difference. The dentist simply takes a loss, writing off the remaining portion of the bill. 

Frequently Asked Questions

  • Will my premiums stay the same over the years?
  • Does AARP have dental coverage?
  • Does dental insurance include coverage for oral surgery?
  • How do I know what’s covered by a Dental PPO (DPPO)?
  • Can Medicare cover my dental costs?
  • Will Medicaid help me with my dental costs?
  • As a veteran, can I get dental care covered by Veteran’s Affairs (VA)?
  • Can you provide an example of how balance billing works in dental plans?

Works Cited

  1. “Essential Health Benefits.” Healthcare.gov, 2020, https://www.healthcare.gov/glossary/essential-health-benefits/. Accessed 13 December 2020.  
  2. “Dental Benefits Improve Access to Dental Care.” NADP, 28 March 2009, https://www.nadp.org/docs/default-source/HCR-Documents/nadphcr-dentalbenefitsimproveaccesstocare-3-28-09.pdf. Accessed 13 December 2020.
  3. “What are the different types of dental benefits products?” NADP, 2020,  https://www.nadp.org/Dental_Benefits_Basics/dental_bb_10. 23 November 2020.  
  4. Overall Customer Satisfaction Increases among Dental Plan Members, J.D. Power Finds.” JD Powers,  06 November 2019, https://www.jdpower.com/business/press-releases/2019-dental-plan-satisfaction-report. Accessed 29 November 2020.   
  5. “GUIDE TO BEST’S FINANCIAL STRENGTH RATINGS (FSR).” AM Best, 2019, http://www.ambest.com/ratings/guide.pdf. Accessed 27 November 2020. 
  6. “Dental services.” Medicare, https://www.medicare.gov/coverage/dental-services. Accessed 13 December 2020.  
  7. “Dental Care.” Medicaid, https://www.medicaid.gov/medicaid/benefits/dental-care/index.html. Accessed 13 December 2020. 
  8. “Eligibility.” Medicaid, https://www.medicaid.gov/medicaid/eligibility/index.html. Accessed 13 December 2020.  
  9. “VA Dentistry – Improving Veterans’ Oral Health.” VA, 10 September 2020, https://www.va.gov/dental/#:~:text=VA%20offers%20comprehensive%20dental%20care,care%20in%20Fiscal%20Year%202019.&text=If%20not%20eligible%2C%20Veterans%20enrolled,Dental%20Insurance%20Program%20(VADIP). Accessed 14 December 2020. 
  10. “VA dental care.” VA, 22 June 2020,  https://www.va.gov/health-care/about-va-health-benefits/dental-care/. Accessed 14 December 2020.