Dental insurance companies in Arizona
As an independent insurance agent, I understand the importance of finding the right dental insurance coverage for your needs. In Arizona, various dental insurance companies offer an array of plans designed to meet the diverse requirements of individuals and families. Whether you’re looking for comprehensive coverage or just the basics to maintain your oral health, there’s a plan out there for you.
In this article, we’ll explore the landscape of dental insurance companies in Arizona, explore the types of plans available, discuss costs and premiums, and provide insights into coverage details. We’ll also touch on the significance of network providers, the claim process, customer satisfaction, and an independent insurance agent’s invaluable role in guiding you through the selection process. With this information, you’ll be better equipped to decide your dental insurance needs.
Types of Dental Insurance Plans available in AZ
Preferred Provider Organizations (PPO)
Preferred Provider Organizations (PPO) are a type of dental insurance plan that allows you to choose any dentist for your dental care, whether they are in or out of the network. However, your costs may be higher with out-of-network dentists. PPO plans typically cover preventive care and basic services. For example, Humana offers several PPO dental insurance plans in Arizona.
Dental Health Maintenance Organizations (DHMO)
Dental Health Maintenance Organizations (DHMO) are another type of dental insurance plan. These plans require selecting a primary care dentist from within a specific network. The selected dentist is a gatekeeper, determining when patients should be referred to specialists for treatment. DHMO plans often cover preventive, basic, and major services with fixed fees and no deductibles. For instance, Humana offers a DHMO plan that covers preventive services 100% with no deductible.
Indemnity Plans
Indemnity dental insurance plans, or traditional dental insurance, are fee-for-service plans that reimburse an enrollee for a portion of covered dental expenses. These plans allow you to choose any licensed dentist for routine, preventive, diagnostic, and emergency dental care. However, indemnity plans tend to be more expensive than other types of dental insurance plans.
Discount or Referral Plans
Discount or referral plans are technically not insurance plans. The company selling the plan contracts with a network of dentists. Contracted dentists agree to discount their dental fees.
Dental Insurance Costs and Premiums in Arizona
The costs associated with dental insurance in Arizona include premiums, copays, coinsurance, deductibles, and annual maximums. The average dental insurance premium in Arizona is approximately $31.17 per month. However, the price can vary based on zip code, age, gender, and coverage level.
**Premiums** are the monthly amounts paid for the insurance coverage. They can range from $30 to $100 per month for adults purchasing stand-alone or family coverage.
**Copays** are fixed amounts a policyholder pays for specific services during the visit. For example, Blue Cross Blue Shield of Arizona offers plans with set copays and no deductibles or annual maximums for providers in certain counties.
**Coinsurance** is the percentage of the cost of services the insured is responsible for after the deductible is met. For instance, a plan might cover 80% of the cost of a service, leaving the insured to pay the remaining 20%.
**Deductibles** are the amounts the insured must pay out-of-pocket before the insurance company begins covering their share of the costs. Deductibles can vary, with some plans having a $50 per person deductible for combined basic and major services.
**Annual Maximums** are the total amount the insurance company will pay for covered services within a year. For example, some plans may have an annual maximum benefit of $1,500 per person.
Individuals must consider these costs when choosing a dental insurance plan and compare the coverage levels and out-of-pocket expenses associated with different plans. Additionally, some plans may have waiting periods for certain services or may not cover certain types of care, so it’s crucial to read the fine print and understand the specifics of each plan.
Leading Dental Insurance Companies in Arizona
Several major dental insurance companies in Arizona provide services to individuals, families, and businesses. These include Delta Dental of Arizona, UnitedHealth, Ameritas, and Humana. Aetna, Cigna, Delta Dental of Arizona, MetLife, Anthem, Spirit Dental, and Blue Cross Blue Shield of Arizona.
It’s important to note that the specifics of each plan, including coverage details and costs, can vary. Therefore, it’s recommended to thoroughly research each plan and consult with the insurance provider to understand the full details of the coverage.
Delta Dental
**Delta Dental of Arizona** is the leading dental insurance company in the state, covering more than 1.4 million individuals. With nearly 50 years of experience, it offers a variety of dental, vision, and COBRA/FSA/HSA plans. Delta Dental of Arizona is a not-for-profit organization with a mission to improve health and wellness. It has the largest network of dentists nationwide, providing access to affordable and quality dental care.
Humana
**Humana** offers a variety of dental insurance plans, including PPO plans that do not require you to choose a primary care dentist. Humana’s dental plans cover preventive care and offer immediate coverage for basic and major procedures when you switch plans. The company also provides access to a nationwide network of more than 325,000 dentists.
Aetna
**Aetna** provides dental insurance plans that cover in-network preventive care 100% with no out-of-pocket cost. The company also offers a dental discount card that provides instant savings of 15 percent to 50 percent off the cost of most services. Aetna has a nationwide network of more than 420,000 dental practices. They have a large network of dentists and offer discounts on orthodontic services.
Cigna
**Cigna** offers affordable dental insurance plans, including options that bundle vision and hearing coverage. The company provides benefits up to $3,650 with the Cigna Dental Vision Hearing 3500 plan. Many of Cigna’s dental plans cover 100% of preventive dental services aside from a copay during the visit. They have an extensive network of dentists and offer discounts on orthodontic services.
Blue Cross Blue Shield of Arizona
Blue Cross Blue Shield of Arizona is a health insurance company that offers dental insurance plans in Arizona. They offer a variety of dental plans for individuals, families, and employers. Blue Cross Blue Shield of Arizona’s dental plans cover preventive, basic, and major dental services. They have an extensive network of dentists and offer discounts on orthodontic services.Blue Cross Blue Shield is a well-known insurance provider with a broad network of healthcare professionals
Ameritas
**Ameritas** provides affordable dental and vision plans, which can be a great supplement to Medicare and Marketplace health care plans. Ameritas dental plans are recognized for their coverage of adult and child orthodontic treatments.
They offer a variety of dental plans for individuals, families, and employers. Ameritas’ dental plans cover preventive, basic, and major dental services. They have a large network of dentists and offer discounts on orthodontic services.
Metlife
**MetLife** offers comprehensive dental coverage for a broad range of services and procedures. Their Preferred Provider Organization (PPO) plans feature the MetLife Preferred Dentist Program, designed to save you money on dental services. You can choose from thousands of participating dentists and enjoy lower out-of-pocket costs for in-network services. MetLife also provides dental coverage for veterans, their families, and CHAMPVA members.
Anthem
**Anthem** offers individual dental insurance plans that cover preventive care like regular cleanings, exams, X-rays, and procedures like fillings, crowns, and root canals. They also offer coverage for orthodontics and dentures. Anthem’s PPO plans typically use a 100/80/50 coinsurance structure, covering 100% for preventive care, 80% for basic procedures, and 50% for major procedures. However, the exact coverage may vary depending on the specific plan.
UnitedHealthcare
**UnitedHealth** offers dental insurance plans underwritten by Golden Rule Insurance Company. These plans include Dental PPO and Dental HMOs. Dental PPO plans typically have higher premiums but offer a wider network of dentists and dental providers. On the other hand, Dental HMOs generally have lower premiums and a restricted network of dentists and dental providers.
Spirit Dental
**Spirit Dental** offers full-coverage dental insurance plans with immediate benefits for dental implants, crowns, root canals, bridges, and more. All Spirit dental plans offer immediate dental coverage on preventive, basic, major, and orthodontic services. Spirit PPO dental plans are part of the Ameritas network, which includes a large number of dental providers nationwide. Spirit Dental also offers high annual maximums to help cover the cost of more expensive dental procedures.
| Company | Individual Coverage | Family Coverage |
|---|---|---|
| Spirit Dental | $26 - $70 per month | $21.81 - $83.76 per month |
| UnitedHealthcare | $16.27 - $40.88 per month | $41.81 - $93.76 per month |
| Metlife | $7.67 - $9.97 per pay period | $25.49 - $30.59 per pay period |
| Ameritas | $21.81 - $39.76 per month | $54.81 - $93.76 per month |
| Blue Cross Blue Shield | $28.81 - $43.76 per month | $29.81 - $73.76 per month |
| Cigna | $31.81 - $93.66 per month | $23.81 - $88.76 per month |
| Aetna | $22.82 - $89.50 per month | $51.81 - $113.76 per month |
| Humana | $21.21 - $103.06 per month | $61.81 - $99.76 per month |
| Delta Dental | $19.81 - $79.76 per month | $49.81 - $79.71 per month |
Choosing the Right Dental Insurance Company
When choosing a dental insurance company in Arizona, assessing your dental care needs, comparing plans and costs, considering in-network dentists, and evaluating customer service is vital.
Assessing Your Dental Care Needs
Before choosing a dental insurance plan, it is crucial to assess your dental care needs. Consider factors such as the frequency of dental visits, the type of dental services you require, and your budget.
Comparing Plans and Costs
Compare the plans and costs of different dental insurance companies in Arizona. Look for a plan that offers the coverage you need at a price you can afford. Consider the monthly premiums, deductibles, and out-of-pocket costs.
Considering In-Network Dentists
Check if your preferred dentist is in-network with the dental insurance company you are considering. In-network dentists have agreed to accept negotiated service rates, which can save you money.
Evaluating Customer Service
Evaluate the customer service of the dental insurance company. Look for a company that is responsive, helpful, and easy to work with.
Enrolling in Dental Insurance
When enrolling in dental insurance, you need to know how to apply, the difference between open enrollment and special enrollment periods, and the documents and information needed for enrollment.
Dental coverage details in Arizona
Dental insurance typically covers a range of services, broadly categorized into preventive care, basic procedures, and major procedures.
Preventive Care
Preventive care includes routine exams, cleanings, X-rays, and sometimes fluoride treatments and sealants. These services are often covered at 100% by dental insurance plans, meaning they won’t cost you out-of-pocket, although there may be limits on how many you can get each year.
Basic Procedures
Basic procedures include treatments like fillings for cavities. Most dental insurance plans cover fillings, but the coverage is not usually 100%; you’ll still have some fees involved that you’ll need to pay out of pocket. The coverage for fillings can vary, but it might be around 25-50% after you’ve paid your deductible or co-pay.
Major Procedures
Major procedures include services like crowns, root canals, and oral surgery. Coverage for these procedures can vary significantly between insurance plans. For example, some plans may cover 50% of the cost of dental crowns. Major procedures like root canals and oral surgery may be partially covered, but the exact percentage can vary.
Limitations and Exclusions
While dental insurance covers a wide range of services, limitations and exclusions exist. For instance, cosmetic procedures are often not covered. Additionally, there may be waiting periods for certain procedures, and some treatments may only be covered up to a certain dollar amount per year. Some plans may also have frequency and age limitations for certain services.
It’s also important to note that coverage can vary depending on whether you use an in-network or out-of-network provider. Using an in-network provider can often result in lower out-of-pocket costs.
Network Providers
When choosing a dental insurance plan, one of the key factors to consider is whether your preferred dentist is within the carrier’s network. This is because in-network providers have agreed to negotiate rates with the insurance company, which typically results in lower out-of-pocket costs for covered services than out-of-network providers.
In-network dentists are part of the dental insurance carrier’s network and have contracted to provide services at specific rates. Patients can take full advantage of their dental benefits by visiting an in-network dentist, including lower copays, coinsurance, and deductibles. Additionally, the annual maximum benefits from the insurance plan may cover more care when using an in-network provider.
For example, Delta Dental’s PPO Plus Premier network offers access to an extensive network of dentists who have agreed to accept lower fees for services, which translates into actual cost savings for the insured. Similarly, by choosing in-network providers, patients can get 100% coverage from their insurance for preventative care like cleanings and regular checkups and possibly higher coverage percentages for more complex treatments.
It’s also important to note that out-of-network providers have not entered into contractual agreements with the insurance company, which often means higher out-of-pocket costs for the patient. While out-of-network dentists may still accept insurance, the lack of pre-negotiated fees can result in higher charges for services.
To determine if a dentist is in-network, patients can check their insurance provider’s website, contact the dental office directly, or call their insurance company. It’s recommended to verify the in-network status of a dentist before receiving treatment to ensure cost savings and coverage are maximized.
Role of an Independent Insurance Agent
An independent insurance agent, such as Blake Insurance Group, is crucial in helping customers find the perfect dental insurance policy for their needs. Independent agents work with multiple insurance carriers, unlike captive agents representing a single insurance company. This allows them to offer a broader range of policy options and price points, making it easier for clients to find a plan that fits their needs and budget.
Here’s how the process typically works:
**Understanding Client Needs**: The independent agent first understands the client’s specific needs, including their budget, preferred dentists, and the type of dental procedures they anticipate needing.
**Comparing Policies**: The agent compares policy options from different carriers. They examine coverage levels, costs (including premiums, deductibles, and out-of-pocket maximums), network restrictions, and customer service ratings. This comprehensive comparison allows them to identify the best options for the client.
**Presenting Options**: The agent presents the best options to the client, explaining the pros and cons of each. They help the client understand complex insurance terms and conditions, ensuring the client makes an informed decision.
**Assisting with Enrollment**: Once the client has chosen a plan, the agent assists with the enrollment process. This includes filling out the application form and setting up premium payments.
**Ongoing Support**: Even after the policy is purchased, the independent agent continues to provide support. They can assist with policy changes, answer questions, and help with claims filing and resolution.
In addition to these services, Blake Insurance Group offers online buying tools allowing clients to buy dental insurance instantly. Clients can compare plans, get quotes, and purchase a policy all from the comfort of their home. This online tool provides clients a convenient and efficient way to secure dental insurance coverage.
Frequently Asked Questions
- What is the average cost of dental insurance in Arizona?
- The average dental insurance premium in Arizona is approximately $31.17 per month. However, the actual prices can vary depending on factors such as zip code, age, gender, and coverage level.
- How much do most people pay for dental insurance?
- The cost of dental insurance can vary widely based on the plan, location, and individual circumstances. On average, adults who purchase their own or family stand-alone dental coverage through the exchange in Arizona pay premiums ranging from $31 to $104 per month.
- What is the most common type of dental insurance?
- The most common types of dental insurance plans are Preferred Provider Organizations (PPO), Dental Health Maintenance Organizations (DHMO), Dental Discount Plans, and Managed Fee-for-Service Plans. Among these, PPO is one of the most common types of plans available.
- Does Arizona Medical cover dental?
- Yes, Arizona's Medicaid program, known as the Arizona Health Care Cost Containment System (AHCCCS), does cover certain dental procedures. However, the covered services can differ based on enrollment. Adults enrolled in Medicaid in Arizona are eligible to receive up to $2,000 in total dental services divided between diagnostic/preventive and emergency dental care.