Dental insurance is a special type of protection that makes your oral health care easier to afford. Dental insurance can help you keep your smile healthy by helping you pay for dentist visits, cleanings and procedures like root canals and fillings. However, while you might understand the basics of what dental insurance is, you might not know what it covers — or where to get it.
Today, we’re giving you a crash-course in everything you need to know about dental insurance in the Keystone State. Read on to learn a little more about what dental insurance is, what is does and doesn’t usually cover and how much you can expect to pay. We’ll also introduce you to a few of our favorite dental insurance providers in Pennsylvania.
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The Best Dental Insurance in Pennsylvania
- Best Overall: UnitedHealthcare
- Cheapest: Humana
- Best for $0 Deductibles: Physicians Mutual
- Best Customer Service: Cigna
- Best for New Residents: Guardian DIrect
- The Best Dental Insurance in Pennsylvania
- Types of Dental Coverage
- What Does Dental Insurance Cover?
- What Does Dental Insurance Not Cover?
- Average Cost of Dental Insurance in Pennsylvania
- What to Look for in a Dental Insurance Provider
- Best Dental Insurance Providers in PA
- Getting the Coverage You Need for a Healthier Smile
- Frequently Asked Questions
Types of Dental Coverage
If you’ve ever navigated the labyrinth that is the U.S. health insurance industry, you’ll be pleased to learn that dental insurance is much less complicated. When you compare plans, you’ll usually see 2 unique plan types:
- Dental health maintenance organizations (DHMOs): When you enroll with a DHMO, you’ll receive a list of in-network dental service providers. If you want to use your benefits, you’ll need to choose a service provider who works in your network — otherwise, you’ll pay for 100% of your dental care costs. DHMOs give you the least amount of freedom to choose which dentist you see, but they’re almost always less expensive than PPOs.
- Preferred provider organizations (PPOs): With a PPO, you can use your dental insurance benefits with any dentist you like. Though the best dental insurance companies will give you an additional discount if you see an in-network dentist, there’s no requirement that dictates who you can see like with a DHMO. PPO plans are more expensive than DHMOs, but they can be worth the extra cost if you already have a dentist you enjoy seeing.
You may also see some companies offer “benefit plans” or “discount plans.” These plans offer you a percentage discount on dental services if you agree to see an in-network dentist. They don’t actually pay for any percentage of your treatment cost, so they aren’t technically a form of insurance. In this article, we’ll limit our reviews only to providers who offer insurance plans.
What Does Dental Insurance Cover?
Unlike health insurance providers, dental insurance providers don’t have a set list of required benefits that they need to provide to all of their policyholders. Dental insurance companies have unlimited freedom to choose which services they want to cover and what percentage of treatment costs they’ll pay. This can make comparing plans frustrating and time consuming.
The most common dental benefits schedule is the “100-80-50” schedule. If you have a 100-80-50 plan, it means that your insurance will cover these:
- 100% of preventive care costs: Preventive care includes routine treatments and services meant to prevent dental disease. Cleanings, x-rays and exams are all usually considered preventive treatments.
- 80% of basic service costs: Basic services are common corrective treatments. Most dental insurance plans consider root canals, cavity fillings and simple extractions to be basic services.
- 50% of major service costs: Major services are invasive and rare procedures that correct large dental health issues. Bridges, crowns and dentures are all usually considered major procedures.
Keep in mind that each individual insurance company can choose which procedure falls into which category. Though many insurance companies consider root canals to be basic procedures, for example, some classify them as major procedures and offer a lower coverage amount. Consult your unique plan or contact a representative to learn more about your individual benefits.
What Does Dental Insurance Not Cover?
No matter what type of dental insurance you choose, there are a few treatments you won’t have coverage for:
- Cosmetic services: No dental insurance plan includes coverage for cosmetic dental treatments like teeth whitening or cosmetic veneers.
- Preexisting conditions: Dental insurance companies often limit or deny benefits for dental health issues that you already have when you sign onto a plan. If you have a chronic or long standing oral health problem, expect your benefits to be limited.
- Orthodontics: Most dental insurance plans don’t include coverage for orthodontics. If your plan does include orthodontics benefits, they will likely be limited to children on your plan under the age of 19.
Average Cost of Dental Insurance in Pennsylvania
Dental insurance in Pennsylvania costs about the same as dental insurance throughout the U.S. For an individual plan, expect to pay between $30–$45 per month.
What to Look for in a Dental Insurance Provider
With so many dental insurance choices, how can you tell which plan you should choose? Unfortunately, not every dental plan is equally valuable. When you compare plans, look for these 3 key characteristics:
- A high deductible: Your plan’s deductible is the minimum amount of money you need to spend on your own insurance before your insurance benefits begin. For example, if you have a $100 deductible, you need to spend $100 on dental bills — after that, your insurance starts covering a percentage of your bills. Choose a plan with a low deductible that you can afford.
- A high maximum benefit cap: Most dental insurance plans include an annual maximum benefit cap that limits how much money your insurance pays out each year. Choose a plan with a high maximum benefit cap to get the most out of your insurance.
- A long list of included benefits: As previously mentioned, dental insurance companies can pick and choose which procedures and treatments they want to include in their plan. Look for a dental insurance plan that includes coverage for plenty of dental issues — especially if you have recurring root canals or cavities.
Best Dental Insurance Providers in PA
Now that you understand the basics of the dental insurance industry, it’s time to start comparing plans. Let’s take a closer look at some of our favorite companies providing dental insurance in Pennsylvania.
1. UnitedHealthcare: Best Overall
UnitedHealthcare is one of the largest providers of health insurance in the United States — but did you know that it also has an impressive offering of dental insurance as well? UnitedHealthcare plans include no deductible or waiting period for preventive services, and it includes coverage for basic and major procedures at affordable rates.
Plans are available from as little as $23 per month in most parts of the state. UnitedHealthcare offers 10 plan tiers, giving you the most choice when it comes to balancing costs and coverage. With affordable prices and plenty of plans, UnitedHealthcare is our top choice for dental insurance in Pennsylvania.
2. Humana: Cheapest Dental Insurance
Just looking to get your hands on the most affordable dental insurance out there? Your first step is getting a quote from Humana. Humana offers some of the most affordable plans in Pennsylvania, with PPO coverage available from just $18 per month.
Humana’s plans also include incredibly low deductibles as well — individuals will pay just $50 per year, while families will pay $150 per year, no matter your plan tier. Low premiums plus low deductibles make Humana our top choice for the Pennsylvanian looking to save.
3. Physicians Mutual: Best for $0 Deductibles
Choosing a plan with a high deductible can actually mean losing money by having dental insurance if you don’t reach it before the end of the year. Looking to skip the math and ensure that your plan is saving you money?
Physicians Mutual offers PPO coverage plans starting at just $25 per month for individuals, and you can choose from 3 plan tiers. Its plans also include no annual or lifetime maximums on the amount of cash benefits that you can collect — a rare benefit that can be invaluable if you run into an expensive dental issue.
4. Cigna: Best Customer Service
With so many plan specificities, it can be comforting to know that you have a responsive customer service team on your side. When it comes to customer service and assistance, Cigna takes the top spot in Pennsylvania.
Its customer care team is available 24 hours a day, 7 days a week to help you understand what your plan covers, which dentists you can see and more. Its network also includes over 90,000 individual dentists offices, so you won’t have trouble finding an office, no matter where you live.
5. Guardian Direct: Best for New Residents
One of the toughest parts of moving to a new state is finding a new set of reliable medical service providers who accept your insurance. Guardian Direct doesn’t just make it easy to find a new dental insurance plan — they can also help you find a new dentist.
Simply enter your ZIP code and Guardian Direct will show you a list of dentists near you and which Guardian plans they accept. Guardian Direct’s plans are also exceptionally affordable, beginning at just $21 per month.
Getting the Coverage You Need for a Healthier Smile
Comparing dental insurance plans can be time-consuming, frustrating and confusing. But the best way to ensure that you aren’t overpaying for your coverage is to consider as many plans as possible.
Before you choose a dental insurance plan, be sure to get quotes from at least 5 competing insurance providers. Getting a quote is quick and easy — you can see your choices in as little as 60 seconds — and allows you to see exactly what your options are. You can’t be sure that you’re getting the best coverage for your family unless you know what’s offered.
Frequently Asked Questions
1) 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.
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: 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.