California Dental Insurance: Coverage and Options

Keeping a healthy mouth is important to both your physical and mental well-being. Without dental insurance, however, the cost of routine check-ups, cleanings, and necessary procedures can quickly add up. In California, dental insurance options vary, and it’s important to know what coverage you have and what options are available.

Types of Dental Insurance

There are two main types of dental insurance: HMO and PPO. HMO, or Health Maintenance Organization, plans generally have lower monthly premiums and require you to choose a primary care dentist who is in the network. PPO, or Preferred Provider Organization, plans offer more flexibility in choosing a dentist, but often have higher monthly premiums.

Some employers offer dental insurance as part of their benefits package, while individual plans can also be purchased through the Covered California health insurance marketplace or directly from insurance companies.

What Does Dental Insurance Cover?

Dental insurance plans vary in what they cover, but most typically include some or all of the following:

It’s important to note that there is often a waiting period before certain procedures are covered, and some plans may have yearly maximums or exclusions for certain conditions.

FAQs about California Dental Insurance

What is the California Dental Network?

The California Dental Network is a collection of dentists and dental facilities that accept certain types of dental insurance. Participating in-network providers typically offer lower costs for covered services than out-of-network providers.

Can I change my dental insurance during open enrollment?

If you have dental insurance through your employer, you can generally only change your coverage during the open enrollment period, which typically happens once a year. If you have an individual plan, you may be able to change your coverage at any time.

What is the difference between deductibles and copays?

A deductible is the amount you have to pay out of pocket for covered services before your insurance starts covering the costs. A copay, on the other hand, is a set amount you pay for each covered service. For example, you may have a $50 deductible and a $20 copay for a filling.

Can I see any dentist with PPO insurance?

With a PPO dental insurance plan, you have more freedom to choose any dentist you want, but you’ll generally pay less if you see an in-network provider.

Are there any dental insurance options for low-income individuals in California?

Yes, the Medi-Cal program provides dental coverage for eligible low-income individuals and families. You can check your eligibility and enroll through the Covered California website.

Conclusion

Dental insurance can help make routine check-ups and necessary procedures more affordable. In California, HMO and PPO plans are available through employers or the Covered California health insurance marketplace. It’s important to understand what is covered and what the potential costs may be before choosing a plan. Utilizing in-network providers and taking advantage of preventive care can also help save on dental expenses.