Texas Dental Insurance Plans

Just like medical insurance, it is very important to have dental coverage as well. Dental insurance provides benefits for an affordable price. It makes it easy to see a doctor for checkups, regular dental cleanings and preventive treatments like fillings etc. All of these are essential in keeping the mouth healthy and also make a big difference in the general health of a person.

What to expect:

Dental insurance also provides benefits for set rates or premiums. There are different plans to choose from. Each plan has particular doctors as part of the network. Differences are felt in the following areas:

  • Dentists one can see
  • Out of pocket costs for patients
  • How treatments are paid for

Procedures and Coverage:

The procedures usually needed and the costs of those will differ by insurance carriers. Procedures and prices will also differ based on plans with each company. Similar coverage offered by all carriers are:

  • Basic coverage: Under this plan, a set number of checkups and cleanings are offered every year. Pay a percentage of the price based on the chosen plan. This is preventive care.
  • Minor Care: This covers minor issues experienced by patients, most of them common. Fillings and other procedures which require more work than a cleaning fall under this category.
  • Major care: Major procedures like extractions, root canals, surgery, dentures and bridges fall under this category. Most policies cover just a fraction of the costs, which are still a big help as these can be very expensive.

Keep this information in mind while shopping around so that you have the necessary coverage. It is also a good idea to keep pre-existing conditions in mind while buying a policy so that you have access to affordable dental care.

Dental Insurance Plans in Texas:

Consumers can choose from 5 different plans in Texas. Each one differs on the basis of services and payment schedules. Choose the best one for your family based on this information. The plans are:

Discount Dental Plans: As the name suggests, patients get discounts on different services when they pay a set amount every month or annually. A discount card offers access to different services at lower rates, determined by a fee schedule. Patients have to pay the discounted price at the time of the visit.

DHMOs:Dental Health Maintenance Organizations can be described as managed care plans. Here, patients pay a monthly or annual fee and become part of a group and get services for very low prices. Dentists get incentives to offer the highest quality care so that patients don’t come for too many free procedures. These plans usually charge high rages for services not mentioned in the plan. Make sure to check included procedures and the dentists who participate in the network.

Preferred Provider Organizations (PPO): Patients have access to plans under which a group of dentists agree to discounted rates and have a larger number of patients. The reimbursement plans are very streamlined. Patients can pick from a list of dentists – it pays to check what services are provided by dentists. Check out what emergency care is covered.

Fee Schedule Plans: Similar to PPOs, they provide care at discounted rates. Patients have access to a list of dentists. Paying for services will differ – a fee schedule or list of prices determines what procedures cost. Patients are responsible for charges beyond the price quoted on the fee schedule. Check to see how often these fees are changed and also how often they are communicated to patients.

Indemnity Plans: Also known as traditional plans, providers pay a percentage for procedures. There is a ceiling on the amount – like a fee schedule plan. Insurance providers make payments only after they receive and review bills. In this case, patients usually pay more out of pocket than if they had a DHMO plan. The big advantage is that they get a wider selection of dentists to choose from. As with any plan, make sure to find out how often the fee schedule is changed.

Dental Insurance Plans

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Below are some of Dental Policies in Texas

Aetna Dental

  • True Advantage

American National

  • Confident Smile
  • Perfect Smile

Careington International

  • Plan 500
  • Plan 500 Multi Care
  • Plan 500 Total Care

Delta Dental Insurance Co.

  • Dental for Everyone
  • Dental for Everyone Gold
  • Dental for Everyone Gold PPO
  • Dental for Everyone Gold PPO/Vision
  • Dental for Everyone PPO

Humanaone

  • HI 215 Plan
  • Preventive Plus PPO
  • Texas Dental Plan

Compbenefits

  • Plan C550

Nationwide Life Insurance Co.

  • Classic 1500
  • Classic 2000
  • Classic Select 2000
  • PPO Advantage

Patriot Health Inc.

  • Gold Plan 15

Safeguard Dental

  • Classic Choice
  • Premiere Choice

Security Life Insurance Company

  • Option 40
  • Option 42
  • Option 45

Stonebridge (Encore Dental)

  • Plan A
  • Plan B

Symetra Life Insurance Company

  • Preferred 45

BEST Dental Advantage - Gold

Issuer: BEST Life

Metal Level: High

Plan Type: PPO

Customer Service : 1-949-253-4080

Toll Free: 1-800-433-0088

TTY Number: 1-949-222-2134

Dental Deductible -family See Plan Brochure
Maximum Out Of Pocket - individual $700
Maximum Out of Pocket -family $1,400
Routine Dental Services Adult No Charge
Basic Dental Adult 10% Coinsurance after deductible
Major Dental Adult 50% Coinsurance after deductible
Orthodontia Adult Not Covered
Dental Check-Up Child No Charge
Basic Dental Child 30% Coinsurance after deductible
Major Dental Child 50% Coinsurance after deductible
Orthodontia Child 50%

BEST Dental Basic - Silver

Issuer: BEST Life

Metal Level: Low

Plan Type: PPO

Customer Service : 1-949-253-4080

Toll Free: 1-800-433-0088

TTY Number: 1-949-222-2134

Dental Deductible -family See Plan Brochure
Maximum Out Of Pocket - individual $700
Maximum Out of Pocket -family $1,400
Routine Dental Services Adult No Charge
Basic Dental Adult 50% Coinsurance after deductible
Major Dental Adult 70% Coinsurance after deductible
Orthodontia Adult Not Covered
Dental Check-Up Child No Charge after Deductible
Basic Dental Child 45% Coinsurance after deductible
Major Dental Child 65% Coinsurance after deductible
Orthodontia Child 50%

BlueCare Dental 1A

Issuer: Blue Cross Blue Shield of Texas

Metal Level: High

Plan Type: PPO

Customer Service Toll Free 1-855-782-4272

TTY Number: 1-800-746-7289

Dental Deductible - individual $25
Dental Deductible -family $75
Maximum Out Of Pocket - individual $700
Maximum Out of Pocket -family $1,400
Routine Dental Services Adult No Charge
Basic Dental Adult 20% Coinsurance after deductible
Major Dental Adult 50% Coinsurance after deductible
Orthodontia Adult Not Covered
Dental Check-Up Child No Charge
Basic Dental Child 20% Coinsurance after deductible
Major Dental Child 50% Coinsurance after deductible
Orthodontia Child 50%

DentaQuest Dental Plan Family High

Issuer: DentaQuest USA Insurance Company, Inc.

Metal Level: High

Plan Type: EPO

Customer Service : 1-800-334-6277

Dental Deductible - individual $50
Dental Deductible -family $150
Maximum Out Of Pocket - individual $700
Maximum Out of Pocket -family $1,400
Routine Dental Services Adult No Charge
Basic Dental Adult 20%
Major Dental Adult 40%
Orthodontia Adult Not Covered
Dental Check-Up Child No Charge
Basic Dental Child 20%
Major Dental Child 40%
Orthodontia Child 50%

Guardian Family Essentials Plus

Issuer: The Guardian Life Insurance Company

Metal Level: Low

Plan Type: PPO

Customer Service Toll Free: 1-888-600-1600

Dental Deductible - individual $100
Maximum Out Of Pocket - individual $700
Maximum Out of Pocket -family $1,400
Routine Dental Services Adult 10%
Basic Dental Adult 30% Coinsurance after deductible
Major Dental Adult 60% Coinsurance after deductible
Orthodontia Adult Not Covered
Dental Check-Up Child 10%
Basic Dental Child 30% Coinsurance after deductible
Major Dental Child 60% Coinsurance after deductible
Orthodontia Child 50%

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