If you’re searching for dental insurance in California, you’ll know there are plenty of companies offering a variety of dental plans. But how do you know which is the best dental insurance for you? It’s important to research your decision carefully, since having the right insurance can significantly reduce your dental costs.
As you look for the best dental insurance in California for your needs, you’ll come across different options such as:
- Plans for individuals, families and seniors
- PPO and DHMO options
- Dental insurance with no waiting period
- Combined dental and vision insurance
So in this guide we’ll explain what the different options mean, and we’ll also help you compare dental plan providers in California. We hope this information helps you decide on the best solution for your dental care.
Table of contents
- 1 Different types of dental insurance in California
- 2 Dental insurance plan features
- 3 Comparing dental insurance companies in California
- 4 Another way to get cheaper dental care
- 5 Conclusion
Different types of dental insurance in California
There are several different kinds of dental insurance, but when it comes to private dental insurance plans in California there are three main options:
DHMO (Dental Health Maintenance Organization)
With a DHMO plan you usually have to select one primary care provider from a small network of dentists. This dentist then performs or arranges all your treatment.
Premiums are generally lowest with this type of insurance, and often include preventive care at little or no extra cost. Other treatments will require a co-payment, and for major work the discount may be quite small with a long waiting period. DHMO plans often don’t cover braces, implants or any kind of cosmetic work.
PPO (Preferred Provider Organization)
PPO dental insurance gives more flexibility over which dentist you visit, and usually higher levels of cover, but with higher premiums too. With a PPO plan you’ll have a choice of dentists within an approved network. Most providers also let you visit out-of-network dentists, but often with reduced benefits and a more lengthy claims process.
Preventive care is usually included at no extra cost and is available immediately. Basic and major procedures may have a waiting period of anything from 3 to 12 months. Cover is usually more extensive than with DHMO plans and can include implants, orthodontics and teeth whitening.
Also known as dental savings plans, this is not technically insurance but is a good way to get cheaper dental care if you need urgent treatment. Cover is usually immediate, and offers a fixed discount on treatment with selected dentist(s). Discount plans may also include preventive care like checkups, cleanings and x-rays.
The fixed discount structure means no deductibles or annual limits, and usually no tiresome claims forms. However, the discounts you receive may be smaller than with other kinds of dental insurance.
Dental insurance plan features
Affordable dental insurance is not just about finding a low-cost premium. There are other factors that will determine which policy is best for you. You can read our complete guide to US dental insurance for more detailed information, but here are a few things to consider:
The cheapest dental insurance in California is not necessarily the plan with the lowest premium. There are four main costs you need to think about:
- Monthly or annual premium: You pay this in return for your cover, regardless of whether you actually receive any treatment. Only some insurers offer the option to pay monthly.
- Deductible: The amount you must pay yourself for treatment before your insurer covers any costs. May be applied annually or over the lifetime of the policy.
- Co-payment: The amount of each treatment you must pay for out-of-pocket. This can be a fixed amount or a percentage of the total cost.
- Maximum limits: Some policies have an annual or lifetime limit for certain treatments. Once you reach this limit, you pay all costs yourself.
So, you can see there is a lot to consider when calculating which policy is best for you – and it doesn’t help that you can’t predict all your upcoming dental needs.
As a general rule, if you have a history of good oral health then you might just want to choose a basic plan with free preventive care and a low premium. On the other hand, if you know you’ll probably need a lot of work, it could be worth paying a higher premium in return for more generous discounts and lower deductibles.
Cover for braces and implants
Because they are some of the most expensive dental treatments around, dental implants and braces are often excluded from dental insurance plans. When they are covered, it might be with a high co-payment or low lifetime limit. The same goes for cosmetic procedures like teeth whitening.
Check policy details carefully to see exactly what you’ll be able to claim and whether it’s worth paying a higher premium for this extra cover.
Dental insurance with no waiting period means you can get the treatment you need straight away. However, for some work you might have to wait up to 12 months.
It’s common for insurers to offer dental and vision insurance in one package – and sometimes hearing and prescription cover too. If you need these other types of insurance, you’ll probably get a better rate from buying them together.
Remember, some of these features may be worth paying for while others may be of no benefit to you. Consider your options carefully to decide on the best dental plan for you and/or your family.
Comparing dental insurance companies in California
There are many companies that offer dental insurance in California. Below you’ll find details of some of the most popular so you can get an idea of what’s available. Even with this small selection, you’ll see there are many possible options to choose from. At the end is a comparison table so you can easily compare this information.
Delta Dental insurance California
Delta Dental has one of the largest dentist networks in the country. If you choose one of their PPO plans you’ll be able to visit any dentist you like, but many network dentists offer preferential rates so you can save more this way. With one of their DeltaCare USA (DHMO) plans you must select a primary care provider.
There are two Delta Dental PPO plans in California to choose from: Basic and Premium. Both include free preventive care and have a $50 annual deductible. The annual limit for the Basic plan is $1,000 whereas the Premium plan offers $1,500.
Basic cover gives a 50% discount on fillings and simple tooth extractions after six months. There is no cover for more complicated work or any kind of cosmetic procedure.
With Premium cover you pay just 20% for fillings and simple tooth extractions, and 50% for a wide range of other treatments including root canals, dentures, crowns, implants and orthodontic work. Again, these benefits are available after six months.
With DeltaCare plans there is no deductible and no annual maximum; you pay a fixed price for each treatment you need. Different monthly premiums offer different levels of cover, so the more you pay per month the less you’ll pay for the treatment itself. These plans include teeth whitening (co-payment $125) and orthodontics for adults and children (co-payment $2,600 – $2,900).
Dental insurance for seniors in California is provided through AARP, a company which Delta Dental administers.
If you have dental insurance through Kaiser Permanente in California, this may well be provided through the Delta Dental network.
Blue Shield of California
Blue Shield of California has a range of two DHMO and three PPO plans, as well as combined dental and vision insurance. There is also the option to add life insurance to your plan.
Their DHMO plans give access to a network of 26,000 dentists in the state of California while PPO customers have access to a wider network of 38,000 dentists.
Some plans include cover for implant placement and orthodontic work; with some the co-payment is a fixed amount and with others it’s a percentage. With all plans diagnostic and preventive services are free and have no waiting period. On the PPO plans, other treatments have waiting times between 3 and 12 months. You’ll need to check the benefit schedule carefully to see which plan will suit you best.
All Blue Shield of California dental plans terminate at age 65, so are not open to seniors.
Anthem Blue Cross
Blue Cross of California provides dental insurance as Anthem Blue Cross. They offer one DHMO plan and five PPO plans. The DHMO plan has no deductible and no annual limit, but a co-payment is required for everything from checkups to braces.
The cheapest PPO plans only cover preventive and 80% of basic restorative work with an annual maximum of $500. At the upper end of the scale you get an annual limit of $1,000 – $1,250 with 50% cover for major procedures. You may visit any dentist, but network dentists typically offer lower rates.
Orthodontic work is covered with the most expensive plan but with a separate $100 deductible and $500 annual / $1,000 lifetime maximum. This may only be a small proportion of the full cost of braces.
Humana offers three PPO dental plans in California for individuals or families. As a member you may visit any dentist, but discounts with network dentists average 28% in the state.
Differing levels of cover are available with premiums that vary accordingly. These all come with free preventive care and a percentage discount on some other treatments.
Their Dental Loyalty plus plan has no waiting periods but a $150 deductible. Benefits increase over the first three years you hold the policy. So, for example, the co-payment for crowns in the first year is 80%, decreasing to 70% in the second year and 50% in the third. At the same time, the annual maximum increases from $1,000 to $1,500.
Humana also has a special dental insurance plan for veterans and their families. Customers may add vision insurance to their dental plan to save $35 on enrollment fees.
Covered California dental insurance
If you already have health insurance through Covered California you have the option to add on dental insurance. Dental cover is available to individuals, married couples and families with children. It’s not possible to purchase a Covered California dental plan if you don’t have health insurance through them.
With their DHMO plans there is no deductible and no annual limit. If you get family cover, there is a maximum out-of-pocket cost of $350 for an individual child or $700 for two or more. Children – but not adults – can get medically necessary orthodontic work with these plans.
The PPO plans have a deductible of $50 for each adult and $65 for each child, which is waived for diagnostic and preventive care. For adults there is a six-month waiting period for major treatments and an annual limit of $1,500, but these don’t apply for children. There is no cover for implants or adult braces.
Customers have the option to visit an out-of-network dentist, but the co-payment is higher for some treatments.
These are just a few of the dental insurance companies in California, but you can already see how much variation there is from one to the next. In the table below we have summarized the information given in this article.
|Provider||Type(s) of plan offered||Special features|
|Delta Dental||PPO & DHMO||Large network of participating dentists in California with negotiated discounts|
|Blue Shield of California||PPO, DHMO, dental & vision||Six different plans to choose from; some include implants and braces|
|Anthem Blue Cross||PPO & DHMO||Low-cost plans for preventive care only; better prices with network dentists|
|Humana||PPO||Includes a plan for veterans; increasing benefits over 3 years with loyalty plan|
|Covered California||PPO & DHMO||Only available to Covered California health insurance customers; orthodontia cover only for children|
|Details correct at time of writing; check with insurer for current and complete policy details.|
Another way to get cheaper dental care
If you’re looking for a way to save on dental care without having dental insurance, have you considered traveling overseas? Two popular dental tourism towns, Los Algodones and Tijuana, are just over the Mexican border from California. By making the short journey across, you could save 50-70% on major dental work.
Some dentists in Mexico even accept US dental insurance policies, so you might be able to get the double benefit of lower prices and a contribution from your insurer. You’ll need to check your policy to see if your insurance company will allow this, though.
Other countries where you can get low-cost dental care include:
- Costa Rica
- The Philippines
To find out more, read our complete guide to getting dental work overseas.
Whether it’s DHMO or PPO insurance you need, you have plenty of options to choose from. The difficulty can be in working out which dental plan provides the benefits that suit you best. Check the details very carefully to be sure you know what you’re signing up for.
Once you have narrowed down your options, you’ll probably want to check some California dental insurance reviews to find out what other customers think of each provider. Poor customer service is the last thing you want when your teeth are causing you trouble! Online forums and review sites will provide plenty of information about other people’s experiences.
Finally, if your insurance includes preventive care (or it comes with a very low co-payment), be sure to make use of it! Getting regular checkups and cleanings will help keep your teeth in good condition. It also lets your dentist spot any problems early on, before they become too painful or costly to fix. The ADA’s MouthHealthy website has lots of great information about maintaining good oral health.