You likely already know you need health insurance to lessen the impact of your doctor bills and maintain a clean bill of health. You might be surprised to learn that even the Affordable Care Act (ACA)-approved plans don’t include coverage for dental insurance. You’ll need a separate dental insurance plan if you want to protect your smile. But where should you start?
We’re taking a look at some of the best dental insurance providers in Massachusetts. We’ll cover some of the basics you need to know if you’re considering dental insurance, as well as some of the specifics of what your plan will and won’t cover. Make sure you read our comprehensive guide before you choose a plan in the Bay State.
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The Best Dental Insurance in Massachusetts
- Best Overall: Cigna
- Cheapest: Humana
- Best for Orthodontic Coverage: Ameritas
- Best for Small Business Owners: Delta Dental
- Best for Quick Service: Physicians Mutual
- The Best Dental Insurance in Massachusetts
- Types of Dental Coverage
- What Does Dental Insurance Cover?
- What Does Dental Insurance Not Cover?
- Average Cost of Dental Insurance in Massachusetts
- What to Look for in a Dental Insurance Provider
- Best Dental Insurance Providers in MA
- Protect Yourself and Your Smile
- Frequently Asked Questions
Types of Dental Coverage
Have you ever navigated the health care matrix in the United States? If so, you already know that choosing a health insurance plan isn’t always simple. Dental insurance coverage is much easier to understand. There are 2 basic types of dental insurance plans:
- Dental health maintenance organizations (DHMOs): Like a health insurance HMO, DHMOs require that you see a dental service provider within a predetermined network. You usually don’t have the option to see service providers outside of your network. DHMOs are the most affordable type of insurance but also give you the least amount of freedom to choose which dentist you and your family see.
- Preferred provider organization (PPO): A dental PPO is similar to a health insurance PPO. You may choose to see any dental service provider you like and still use your benefits. However, if you do choose to see a service provider within your network, you’ll receive an additional discount from your insurance provider. PPOs give you the freedom to choose which dentists and other dental service providers you see, but you’ll usually pay more for your plan compared to a DHMO.
You may occasionally see an insurance company that offers you a very cheap benefits plan. A benefits plan (sometimes called a discount plan) isn’t technically a form of insurance. Instead, it’s an agreement within a group of dental insurance providers to give you a discount on your services in exchange for continued loyalty. Discount and benefit plans don’t actually pay for any percentage of your care costs, so we won’t consider them in this plan review.
What Does Dental Insurance Cover?
The ACA requires health insurance companies to provide coverage for at least 10 essential benefits. Unfortunately, dental insurance providers aren’t held to a similar standard. There is no standard rubric of benefits that every dental insurance provider must offer coverage for. This can make it more frustrating and time-consuming to choose a plan.
Many dental insurance plans follow a 100-80-50 schedule of benefits. A 100-80-50 plan means that your insurance will cover:
- 100% of preventive care costs: Preventive care refers to regular and routine treatments that help you avoid dental illnesses and disease. Some examples of preventive care include cleanings, X-rays and exams.
- 80% of basic procedure costs: Basic procedures refer to routine treatments that are used to correct common dental and oral health issues. Some examples of basic procedures include fillings for cavities, root canals and crowns.
- 50% of major procedure costs: Major procedures are rare and invasive treatments are used to correct major oral health issues. Some examples of major procedures include bridges, denture fittings and tooth extractions.
Keep in mind that a 100-80-50 benefits schedule is simply the most common insurance benefits package. You aren’t guaranteed to have this set of benefits unless you specifically see it laid out in your plan policy. You should also keep in mind that your insurance company has the freedom to decide which procedures are covered and which fall into each category.
For example, many dental insurance plans consider root canals to be major treatments instead of basic procedures, and many plans also elect not to cover sealants (despite the fact that most dentists recommend sealants as a preventive treatment against cavities).
What Does Dental Insurance Not Cover?
No matter which plan you choose, there are a few benefits that your insurance probably won’t cover, including:
- Cosmetic dentistry: No dental insurance plan will cover 100% cosmetic dental procedures (like teeth whitening).
- Preexisting conditions: Unlike health insurance providers, dental insurance providers have no legal obligation to cover you for preexisting conditions. If you already have a long-standing or chronic dental or oral health issue when you sign up for your plan, your insurance provider may limit or exclude benefits for the treatment of that particular illness. Many insurance plans also have a “waiting period” that prevents you from using your benefits for at least a few months to discourage individuals with preexisting conditions from enrolling.
- Orthodontic treatments: Despite the fact that orthodontic treatments are often required to prevent oral health issues, most plans don’t cover these services for adults. If your plan does include coverage for orthodontics, it will usually only extend to children under the age of 18 who are enrolled in your plan.
Remember that your dental insurance provider doesn’t need to cover any particular treatment or service with your plan. Make sure you thoroughly read your plan inclusions and exclusions before you enroll to avoid any unexpected surprises.
Average Cost of Dental Insurance in Massachusetts
The average cost of independent dental insurance in Massachusetts is similar to the rest of the United States. Individuals can expect to pay between $30 to $45 a month for coverage. Anyone with a family plan can expect to pay between $42 and $71 per month.
What to Look for in a Dental Insurance Provider
Here are a few key factors you should consider as you search for the best dental insurance in Massachusetts:
- Deductibles: Your deductible is the amount of money that you need to spend on your own dental insurance before your insurance kicks in and starts to cover your bills. If your deductible is too high, you may pay more for your insurance than it’s worth. Look for an insurance plan with a reasonable and affordable deductible.
- Maximum benefits: Most dental insurance plans include a maximum dollar amount of benefits you can receive every year. You’ll be responsible for 100% of your dental bills if you hit your maximum. Choose a dental insurance plan with a high maximum benefit limit to get the most for your money.
- Coverage in your state: Like health insurance providers, not every dental insurance provider can provide coverage in your state. Make sure your plan provider of choice offers coverage in your state before you enroll.
Best Dental Insurance Providers in MA
Now that you understand the basics of how dental insurance works, let’s take a look at some of the best dental insurance plans in Massachusetts.
1. Cigna: Best Overall
Cigna offers a variety of dental insurance plans for both individuals and families. Plans are available from as little as $30 a month and its plans all include 100% coverage for preventive care if you choose an in-network provider.
Cigna’s customer service line is available 24 hours a day, 7 days a week — even on holidays. Cigna is our top choice for dental insurance in Massachusetts because it offers comprehensive plan options, a number of choices available and easy-to-access customer service.
2. Humana: Cheapest Dental Insurance in MA
Looking for the most affordable dental insurance in Massachusetts? Don’t forget to get a quote from Humana. Our Humana review revealed that Humana offered plans in Massachusetts for as little as $23 a month — it’s one of the most affordable choices in the state.
All of their insurance plans also function as PPOs, which means that you won’t have to choose another dentist just to fit your insurance. A robust benefits schedule and exceptionally affordable prices mean that Humana is a great choice for both families and individuals who need dental insurance coverage.
3. Ameritas: Best for Orthodontic Coverage
Consider a plan from Ameritas if you have a child who will need orthodontic work. Ameritas is one of the few dental providers in Massachusetts that offers any form of coverage for orthodontia. Plans are available from as little as $35 a month and include coverage for up to $1,000 worth of orthodontic work.
You can also extend your coverage to $1,500 worth of orthodontic benefits for just under $50 a month. This is a major benefit if you know your child will need a large amount of orthodontic treatment.
4. Delta Dental: Best for Small Business Owners
You want to protect your employees without breaking the bank when you own a small business. Delta Dental offers business owners a number of choices, depending on the amount of coverage they want to provide. Delta Dental’s Total Choice PPO offers employees a premium network of dentists and incredible savings offers.
You can also choose a voluntary plan from Delta that offers your employees discounted dental coverage at little to no cost to your company. No matter what type of budget you have, Delta has a plan for you and your team.
5. Physicians Mutual: Best for Quick Quotes
Consider a policy from Physicians Mutual if you need coverage fast. Getting a quote from Physicians Mutual is incredibly simple — just enter your state, your age and the type of plan you need. In our review, it took less than 30 seconds to see prices and policy choices for Massachusetts residents.
You’ll see all of your options laid out in front of you in clear terms with exact explanations of your benefits. All plans include a $0 deductible, so you don’t need to do the math and determine whether you’re overpaying for coverage.
Protect Yourself and Your Smile
Like any other type of insurance, you’ll have tons of options when it comes to protecting your smile. Don’t be afraid to take some time and shop around for a policy before you decide — and always remember to thoroughly read and understand your benefits before you sign.
The last thing you want is to pay for coverage and later find out that you aren’t as protected as you thought.
Frequently Asked Questions
1) Q: What kinds of dental insurance are available?
Your choices for dental insurance plans are similar to health insurance choices. You can choose from a dental HMO, which helps to keep premium costs low by keeping services within controlled network. Dental PPOs give more freedom to choose your dentist and care but cost more than HMO plans. A third option is called a dental indemnity plan, which pays a fixed amount or percentage for covered services. Compare quotes from our top providers for the best price.
2) Q: Is dental coverage part of health insurance?
Some health insurance plans bundle dental coverage as well but, in many cases, dental insurance is a separate plan. Healthcare plans that are ACA-compliant are required to offer dental coverage to children but there is no requirement that adults have dental insurance coverage. Choosing a separate dental insurance plan can be a cost-saving step and helps make dental health costs more predictable. Check out our best providers for the cheapest rate.
3) Q: How does dental insurance work?
A dental insurance plan charges a premium in exchange for covered benefits. Unlike health insurance plans, dental insurance plans usually have a cap on benefits, which means your plan may stop providing coverage once you reach the annual cap, often between 1k and 3K. Like other types of healthcare insurance, dental insurance focuses coverage on essential services, like cleanings, fillings, etc. Many plans don’t cover braces or elective cosmetic procedures. Get the cheapest premium here.