Whether you’re a small business owner looking to offer dental coverage or an individual interested in stand-alone dental insurance, eHealth has you covered. Here’s a breakdown of the different dental plan options and how to find dental coverage that fits your needs. Once you’re ready, visit our Florida Dental Insurance  page to begin shopping for plans and getting quotes.

Why dental insurance is essential in Florida

If you don’t get dental insurance through an employer, you may be wondering if it’s worth buying on your own. If you have generally healthy teeth, you may feel like you don’t want to pay for the coverage.

The fact is that dental insurance is a key part of preventing oral disease, as well as other, more serious conditions. Most dental plans cover preventive services, such as routine exams and cleanings, that keep your teeth (and ultimately your overall health) intact.

Factors to consider when choosing dental insurance in Florida

According to the American Dental Association:

• 50% of adults over 30 have some form of gum disease.
• Almost 1 in 4 kids under five have cavities.
• 125 conditions are tied to oral health, including heart disease, obesity, diabetes, and more.
• People with diabetes are twice as likely to have gum disease as those without diabetes.

Dental insurance for seniors is just as important as dental insurance for young adults, so it’s important to figure out a way to get the best dental insurance for you. Many employers cover dental coverage or subsidize the cost. If your work doesn’t cover dental insurance, it’s worth noting that many marketplace plans give you the option to add dental coverage. You can also buy dental coverage separately.

If you need help finding health plans with this coverage, an eHealth licensed insurance agent can walk you through your options. Or, you can browse plan options in your Florida location by entering your zip code into the plan finder tool on this page.

Types of Dental Insurance Plans

In this section, we will explore various types of dental insurance plans, helping you understand the differences and choose the one that best suits your oral healthcare needs and budget.

Dental Preferred Provider Organizations (DPPO)

A Preferred Provider Organization (PPO) is a type of dental insurance plan that provides a network of dentists and dental specialists who have agreed to offer services at negotiated, reduced rates to plan members. PPO plans offer flexibility in choosing dentists, as you can see both in-network and out-of-network providers.

This option might be pricier, but it usually offers a lot more flexibility. Employees usually have the option to pick a dentist that they want, including a dentist outside of the plan’s network (although out-of-pocket costs might be higher with an out-of-network dentist). Unlike an HMO plan, if you need to see a specialist, you don’t need to see your primary dentist first for a referral.

Dental Health Maintenance Organizations (DHMO)

A Dental Health Maintenance Organization (DHMO) is a dental insurance plan that requires members to choose a primary care dentist (PCD) from a network of participating providers, and this dentist coordinates and manages the member’s dental care, including referrals to specialists when necessary.

A Health Maintenance Organization may be a more affordable Florida dental insurance option. With this plan, generally you pay less on premiums, but have to use dental professionals in the plan’s provider network.

Dental Indemnity Insurance

Dental Indemnity Insurance, also known as dental fee-for-service insurance, is a type of dental insurance plan that provides policyholders with the flexibility to choose their own dentists and dental specialists without the need for referrals. Policyholders can receive dental care from a wide range of providers, and the plan typically reimburses them based on a fee schedule or a percentage of the dentist’s usual and customary fees. This type of dental insurance plan does not require members to choose a primary care dentist or follow a specific network of providers, offering greater freedom in selecting dental care services and providers.

Dental Discount Plan

A Dental Discount Plan is not insurance but a membership program that provides individuals with access to discounted rates for various dental procedures when they use participating dental providers. Members typically pay an annual or monthly fee to access these reduced rates, and there are no deductibles, copayments, or annual maximums associated with this type of plan. Dental discount plans can be suitable for individuals who prefer an alternative to traditional dental insurance and want to save money on their dental care expenses. They offer flexibility in provider choice and provide access to discounted rates for dental services without the need for a network of dentists or referrals.

What dental insurance in Florida typically covers

In Florida, dental insurance typically covers a range of essential dental services to help individuals maintain their oral health and address common dental issues.

Preventative Care

Preventative care typically includes routine dental check-ups, cleanings, and X-rays designed to identify and prevent common dental issues like cavities and gum disease.

 Basic Procedures

Basic procedures typically cover services such as fillings, root canals, and extractions, which are necessary to address common dental problems.

Major Procedures

Major procedures usually encompass more complex treatments like crowns, bridges, dentures, and oral surgery, which are essential for more severe dental issues.

Orthodontic Coverage (if applicable)

Orthodontic coverage may include services like braces or clear aligners for correcting misaligned teeth and bite issues, often with coverage tailored to specific plans.

Additional benefits to look for in dental insurance

Annual Maximum Coverage

The annual maximum coverage refers to the maximum dollar amount that a dental insurance plan will pay for covered services in a calendar year. Once this limit is reached, the policyholder is responsible for all additional costs.

Waiting Periods

Waiting periods are specific durations during which a dental insurance plan does not cover certain services or procedures, particularly for new policyholders. These waiting periods can vary among plans and may apply to services like major procedures or orthodontic treatment.

Network Coverage

Network coverage relates to the network of dentists and dental providers that are contracted with a dental insurance plan. Seeing in-network providers often results in lower out-of-pocket costs compared to out-of-network providers. It’s a consideration because it can affect the availability of preferred dentists and affordability of care.

Deductibles and Copayments

Deductibles are the initial out-of-pocket amounts that policyholders must pay for covered services before the insurance plan starts contributing. Copayments are fixed amounts paid by the policyholder for each visit or service. These are considerations because they impact the cost-sharing structure of the dental plan.

Leading dental insurance companies in Florida

The best-selling plans for Florida dental insurance at eHealth in 2023 are as follows:

In 2023, there are 11 insurers who offer stand-alone individual/family dental plans through the Florida health insurance marketplace. These are dental plans that are not included with a medical plan and must be purchased separately:

• BEST Life
• Cigna
• Delta Dental
• DentaQuest
• Dentegra PPO
• EMI Health
• Florida Combined Life
• Guardian
• Humana
• Renaissance
• Solstice

Premiums range from $0 to $248 per month for adults who purchase their own stand-alone or family dental coverage through the exchange, with the average being about $53 per month.

According to IHC Specialty Benefits, the mean monthly premium for a standalone dental plan for families in Florida in 2023 stood at $52.54.

Tips for selecting the right dental insurance plan

Assessing Your Dental Needs

Assessing your dental needs is crucial to ensure you choose a plan that covers services you require, such as regular check-ups, cleanings, or specific treatments.

Comparing Plans and Pricing

Comparing plans and pricing allows you to find a dental insurance plan that not only meets your needs but also fits your budget.

Checking Provider Networks

Examining provider networks is important to ensure your preferred dentist or dental clinic is within the plan’s network, reducing potential out-of-pocket expenses.

Reading Policy Terms and Conditions

Carefully reviewing policy terms and conditions helps you understand coverage limits, waiting periods, and other important details that can affect your dental care and costs.

Affordable dental insurance plans in Florida

Government Programs

Government programs like Medicare and Medicaid offer dental benefits for eligible individuals. Medicare may cover some dental services under specific circumstances, while Medicaid and CHIP provide dental coverage for low-income individuals and children.

Discount Dental Plans

Discount dental plans are membership-based programs that offer reduced rates on various dental services when you visit participating providers. They are not insurance but can help you save on dental expenses.

Employer-Sponsored Plans

Employer-sponsored dental insurance plans are typically offered as part of a benefits package by employers. These plans vary in coverage and cost, with some or all expenses shared between the employer and employee.

Medicaid and CHIP

Medicaid and the Children’s Health Insurance Program (CHIP) provide dental coverage for eligible low-income individuals and children, ensuring access to essential dental services for those who qualify.

Frequently asked questions (FAQs)

What does dental insurance cover in Florida?

Dental insurance coverage in Florida typically includes preventive services like routine cleanings, X-rays, and oral exams. Basic procedures such as fillings and extractions are often covered, as well as more complex treatments like root canals and crowns. Some plans may also offer coverage for orthodontic services, dentures, and oral surgery, although coverage levels may vary depending on the specific plan and provider.

Are there waiting periods for dental insurance in Florida?

Yes, there are often waiting periods associated with dental insurance plans in Florida. Waiting periods typically apply to certain types of services, especially more extensive procedures like crowns, bridges, and orthodontic treatment. The length of the waiting period can vary depending on the insurance plan, with some policies requiring a waiting period of several months before coverage for specific procedures becomes effective.

Does dental insurance in Florida cover cosmetic procedures?

Generally, dental insurance plans in Florida do not cover cosmetic procedures that are considered elective or primarily aesthetic in nature. Cosmetic treatments such as teeth whitening, veneers, and cosmetic bonding are typically not covered by standard dental insurance policies. However, some dental insurance plans may offer optional cosmetic coverage as an add-on or through separate cosmetic dentistry plans. It’s essential to review your policy or contact your insurance provider to understand what cosmetic procedures, if any, are covered.

Are there annual maximums on dental insurance in Florida?

Yes, many dental insurance plans in Florida have annual maximums, which are the maximum dollar amount that the insurance company will pay for covered dental services within a policy year. Once you reach the annual maximum, you will be responsible for covering any additional dental expenses out-of-pocket. Annual maximums vary depending on the specific plan and provider, so it’s essential to review your policy details to understand your coverage limits.

Secure your health with the best dental insurance in Florida

Securing the best dental insurance in Florida is crucial for maintaining your oral health without worrying about unexpected expenses. eHealth simplifies this process, offering a wide range of dental plans from reputable carriers, helping you find coverage that aligns with your needs and budget. Visit our Florida Dental Insurance page to begin shopping for quotes today.