Dental Plans

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DISCLAIMER

The lists below are companies who notified the State of Florida they would be selling Dental plans on or off the Marketplace starting 2015.  As of  April, 2015 this list was current, but it may no longer be current.  To get the current list of available dental insurance plans for the companies listed, your are encouraged to visit the website of each company or visit https://www.healthcare.gov/see-plans/.

 

 

Individual Dental Plans that are available on the public exchange but the majority of plans, both individual and group, are available outside of the public exchange.  The most popular delivery of dental services are via DHMO, PPO and Indemnity Plans, which simply refers to the network of dental providers delivering the services.

 

Dental Health Maintenance Organization (DHMO) plans have the lowest monthly premiums and usually have no annual deductibles.  There may be a short waiting period of about 3 months before services begin, but the vast majority of DHMOs have no waiting periods. These plans may offer some Preventative Services requiring no copayments or deductible, but the majority of the services are discounted by the dentists performing the services based upon a schedule of discounted rates created by the plan and accepted by the dentists.  Patients pay the discounted rates at the time of service.  Patients are required to receive service in the DHMO Network for the rates to apply.  There is no coverage outside of the DHMO Network.

 

Preferred Provider Organization (PPO) plans usually have an annual deductible of about $50 to $100 (initial cost share).  Services are broken down into 4 categories: Preventative, Basic, Major and Orthodontic. There may be a short waiting period of up to 3 months before services begin, but the vast majority of PPOs have no waiting period for Preventative Services and with some plans, some Basic Services such as extractions and fillings are covered immediately. Depending on the plan, Basic Services may require up to 6 month wait, Major Services up to 12 months wait and Orthodontic Services up to 24 months. These plans may offer some Preventative Services requiring no copayments after the deductible is met such as one annual cleaning, or one annual exam or a set of x-rays, but thereafter, services require additional cost-sharing and are covered on a copayment or coinsurance basis.

Additional Preventative Services may be covered up to 80% requiring 20% coinsurance (the out-of-pocket amount the patient pays).  Depending on the plan benefits, Basic services may be covered from 60% to 80% requiring from 40% to 20% coinsurance, and Major Services may be covered from 50% to 80% requiring from 50% to 20% coinsurance.  To get these rates, patients will be required to use the PPO Network providers.  Patients may use non-PPO (out-of-network) providers, but the cost sharing percentages will most likely be greater.  However, there are plans that will cover out-of-network services up to 80%.

 

Indemnity Plans allow patients to use any dentist and have no networks.  If you do not want to change dentist or want the freedom to use the dentist of your choice, the Indemnity Plan may be your best bet.  Indemnity plans may have the same waiting period as a PPO plan and quite often mimic the out-of-network features of the PPO plan. Some Indemnity plans require the patient to pay for service and bill the plan for a reimbursement.  Others may simply state that they will cover up to 80% of the billable charges.  Indemnity Plans are popular in rural areas where there are usually not Dental Networks.

 

Not all plans are available in all states and zip codes. You may visit the federal Marketplace website at https://www.healthcare.gov/see-plans/ to determine what plans are available in your zip code. 

 

Additional information may be obtained at:

https://www.healthcare.gov/choose-a-plan/plan-types/

* www.healthcare.gov.

COMPANY

NAME

PHONE NUMBER

WEBSITE

TYPE OF PLANs

Spirit Dental & Vision

1-800-620-5010

Get A Quote

Individual & Group —DHMO, PPO, Indemnity

Blue Cross and Blue Shield of Florida dba Florida Blue

1-800-955-2227- or visit a Florida Blue Center

Get A Quote

Individual & Group -DHMO, PPO

Denali Dental

1-800-620-5010

Get A Quote

Individual & Group PPO

Medico Dental, Vision & Hearing—Medico Insurance Company

1-800-228-6080

Get A Quote

Individual PPO

:Dental Plans

1-866-769-8277

Get A Quote

Group Dental Savings Plan

National General Insurance Company

1-800-847-2446

Get A Quote

Dental Indemnity

Humana Health Insurance Company of Florida

1-877-229-6285

Get A Quote

Individual & Group -DHMO, PPO

Bright Idea Dental & Vision

1-800-979-8266

Get A Quote

Individual PPO

UnitedHealthcare Life Insurance Company

Contact insurance agent.  List of agents is on website. 

Get A Quote

Individual PPO