Having dental insurance is an important part of maintaining good oral health. With the rising costs of dental care, having insurance helps make routine dental visits and procedures more affordable. But with so many dental insurance plans available, it can be tricky to know which type of plan is most common. In this article, we’ll break down the different types of dental insurance and discuss which plans are most prevalent.
Types of Dental Insurance Plans
There are several main types of dental insurance plans available:
- Dental health maintenance organizations (DHMO) – This type of plan requires you to see dentists within a network. Your out-of-pocket costs are typically lower with this type of plan.
- Dental preferred provider organizations (DPPO) – This type of plan allows you to see dentists both in- and out-of-network, but you will usually pay less when seeing an in-network dentist.
- Dental indemnity plans – These plans allow you to see any licensed dentist and the insurance company will reimburse you for covered expenses up to an annual maximum.
- Discount dental plans – This is not insurance, but rather discounted rates on dental services when using dentists within a network.
Prevalence of Dental Insurance Plans
The most recent data from the National Association of Dental Plans indicates that the most common type of dental insurance in the United States is the dental preferred provider organization (DPPO) plan.
Here is a breakdown of the prevalence of different plan types:
| Plan Type | Percentage of All Plans |
|---|---|
| Dental Preferred Provider Organization (DPPO) | 76% |
| Dental Health Maintenance Organization (DHMO) | 16% |
| Dental Indemnity | 6% |
| Discount Dental | 2% |
As you can see, DPPO plans make up over three-quarters of the dental insurance market. DHMO plans make up the second largest share at 16%. Dental indemnity and discount plans round out the rest of the market.
Why are DPPO Plans Most Common?
There are several key reasons why DPPO plans are the most prevalent form of dental insurance:
- Network flexibility – DPPO plans allow you to see any licensed dentist you want, but you’ll pay less when you stay in-network. This appeals to many consumers who want options.
- Predictable costs – DPPO plans negotiate set rates with in-network dentists, allowing you to better predict your out-of-pocket costs for procedures.
- Wide availability – DPPO plans are offered by the majority of dental insurance companies and are often included in employer group plans.
- Simplicity – The coverage and claims process for DPPO plans is relatively straightforward compared to other types of plans.
With their blend of flexibility, affordability, and simplicity, it’s easy to see why DPPO plans are the most popular dental insurance option for many people.
DPPO Plan Benefits and Drawbacks
While DPPO plans have many advantages, there are also some potential drawbacks to consider:
Benefits
- See any dentist – You have the freedom to visit dentists outside of your plan’s network if you wish.
- Lower costs in-network – Paying for in-network dentists saves you money on coinsurance rates.
- No referrals needed – You don’t need permission from a primary care dentist to see a specialist.
- Preventive care covered – Most plans cover routine exams, cleanings, and x-rays at little to no cost.
Potential Drawbacks
- Higher out-of-network costs – You’ll pay more coinsurance when seeing out-of-network dentists.
- Pre-approval needed for major work – Many plans require pre-approval and cost estimates for expensive treatments.
- Benefits limits – Most DPPO plans cap annual spending for coverage.
- Availability varies – While common, DPPO plans aren’t offered in all areas.
Comparing DPPO with Other Dental Insurance Options
How do DPPO plans stack up against other dental insurance choices? Here’s an overview:
VS. Dental Health Maintenance Organizations (DHMO)
DPPO Plans
- See any licensed dentist
- Higher costs for out-of-network dentists
- Little or no charge for preventive care when in-network
- Pre-authorization may be required for major work
- Yearly deductibles and benefit maximums
DHMO Plans
- Must see in-network dentists
- Lower out-of-pocket costs for services
- Copays required for procedures and treatments
- No yearly deductibles
- No annual dollar limits on coverage
VS. Dental Indemnity Plans
DPPO Plans
- Pay less when you stay in-network
- No need to submit claims yourself
- Pre-authorization required for major work
- Out-of-pocket costs may apply even after reaching annual maximum
Dental Indemnity Plans
- Freedom to choose any dentist
- Reimbursement for a percentage of costs for covered care
- Must submit own claims and wait to be reimbursed
- No charges once you hit annual maximum
As you can see, each plan type has pros and cons. DPPO plans offer a balance of provider choice and lower costs that appeal to many consumers.
Who Offers DPPO Dental Insurance Plans?
Many of the top dental insurance providers offer DPPO plans. Here are some of the leading companies to check with:
- Aetna
- Ameritas
- Cigna
- Delta Dental
- Guardian
- Humana
- MetLife
- Principal
- UnitedHealthcare
Most individual and family DPPO plan options will be available through private insurance companies. For employer group plans, the provider options will depend on what your employer chooses to offer.
Key Takeaways
- Dental preferred provider organization (DPPO) plans are the most common, accounting for 76% of the dental insurance market.
- DPPO plans offer a balance of provider choice flexibility and lower costs when staying in-network.
- Benefits include coverage for preventive care and the ability to see out-of-network dentists if desired.
- Drawbacks can include higher out-of-network costs and pre-approval requirements for major work.
- Leading insurance companies like Delta Dental and Cigna offer DPPO plans for individuals and employer groups.
When shopping for dental coverage, be sure to compare different plan types like DHMO and dental indemnity plans. Look closely at costs, coverage, and flexibility to find the right dental insurance fit for your needs and budget.
