Seeking Dental Insurance

Parent Q&A

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  • Self-paid dental insurance

    Apr 3, 2023

    Hi parents. My husband's employer provides us with Delta Dental USA, but they really do not have any pediatric dentists that are covered by our plan. (I just got off the phone with them and even their rep said they really didn't have anything.) Does anyone have a recommendation for a dental insurance plan that covers pediatric dentists in the Oakland/Berkeley area? Or area we better just paying out of pocket for this?

    (I've looked through past posts, but all on this topi are form 10+ years ago.)

    Thanks,
    Ilana

    If you have the option of choosing Delta Dental PPO instead of DeltaCare--some employers offer both, but the PPO costs more--they are in network for several local pediatric practices (including Uptown Pediatrics in Oakland, where our kids go). I've found the DeltaCare network pretty lousy in general. For a couple of years when we didn't have the PPO plan as an option, we just paid out of pocket and it was also pretty reasonable.

    We used to have Delta and our pediatric dentist, who I LOVE, stopped accepting it on Jan 1. Around the same time, my husband’s company switched to Cigna for dental. Our pediatric dentist (Alameda Pediatric Dental) is also out of network but the coverage is actually still decent. For my daughter’s latest exam, cleaning, fluoride, and x-rays my total out of pocket was $17. I had to pay 20% upfront to the dentist and they refunded me the other $60 once they got paid by Cigna. Of course, the actual coverage you would have is determined by whatever plan you choose. But you might want to ask your dentist’s receptionist which insurance company they see offering the best coverage. 

    In my experience in taking my child to a "general dentist" for many years, starting at age 2, you do not need a pediatric dentist for child check ups and cleanings. A general dentist or a family dentist is fine. If the dentist determines your child has a condition that requires a dentist who is pediatric board certified, they will work with you on a referral.

    My employer provides Delta Dental PPO, and an old dentist once told me that most dentists only accept this one.  I don't know if it is available for private purchase

    We have delta dental and my kids went to Aloha pediatric dentistry in Berkeley when we lived in Oakland. That was before Covid time. You can check with them to see if they still take it.  

    We also have Delta and our pediatric dentist (Alameda Pediatric Dentistry) just dropped them. We are now out of network but have continued to see them because Delta pays about 2/3 of the cost for most things. We may reevaluated once our kids need orthodontic work as that rate is lower. But for now the high level of care we get there and the pain of finding something new has kept us there. 

    The way it works is we pay the full cost up front (about $300) and then Delta reimburses us (about $200). The dentist does all the billing, which makes it easy. I know this isn't an option for everyone but it's worked for us so far. This might be cheaper for you than buying additional insurance. 

    A belated thank you for all these inputs! Good to know the difference between DeltaCare and Delta PPO. Though I don't think the PPO was an option for us through out employer, and since DeltaCare is network is so limited, the employer is in the process of changing this anyway. We probably will have to just pay out of pocket for this coverage gap..... we're looking at some of the dentists that offer the 1 year membership packages that include two visits. Thanks!

Archived Q&A and Reviews


Dental Insurance Brokers?

Dec 2012

Hello BPN, My new job does not offer dental insurance. I looked in to getting individual insurance through Delta, and the plans cover almost nothing. I know I will be needing two crowns, so I am looking for something that will at least cover some of the work! When I called my dentist, they recommended I try to find a broker, who takes individuals, and gets them a better rate by putting them together on a group plan. I've done a few internet searches and am not having too much luck. Does anyone have recommendations for how to find such a broker, or have a broker you have used? Have you found their services useful? Thanks for your time. Katie


Hi- I suspect you will be hard pressed to find anything that provides you with the dental coverage you're looking for. I've been in the employee benefits business more than decade and dental insurance has always been disputable because it lacks the inherent risk of life insurance and major medical.

Typically the only individuals who seek individual dental insurance are those who are planning to have major work done. Once you're done with your major work who's to say you wouldn't just cancel the policy making it a losing proposition for the carrier. Annual insurance premiums for individuals run very similar in cost (if not a bit higher) than the annual cost of preventive work. Accordingly, the best risks/individuals planning to just have preventive work opt not to buy individual policies, etc.

Additional thoughts:

-If you thought that you might have 10-15 co-workers that would also want dental insurance perhaps you could approach your employer about putting in a voluntary dental plan. There are group policies out there requiring little to no employer $. Your ER's current broker or myself could help.

-Does your ER offer a medical 125 plan? If so, find out how much your dental bills will be next year and plan to fund your 125 by that amount. At a minimum you pay your dental bills with tax free dollars.

-Have you been going to your dentist for years? If so, perhaps they can reduce their fees for you. If you're not 100% loyal, shop around for either a dentist with lower fees or a dentist that disagrees that you even need a crown (yes-- I've seen that happen.)

danae


Costco Dental Insurance

Nov 2010

Anyone have Costco Dental Insurance? I am wondering how it is and what the premium cost is for family coverage. Many thanks.


I've been really happy with Costco Dental. Their prices just went up to $213.12 for great dental and orthodontic coverage for a full year for a family of four. On the dentist list of providers are many within walking distance of my Albany home and the kids and I love our dentist. However, I'm not so happy with their orthodontic providers. We had selected one in Berkeley when my kids were identified as needing braces but before they were ready to start treatment. Now that provider is off their roster and I'll have to choose between providers in Pinole or downtown Oakland. These orthodontists don't seem to have any solidly positive reviews on line. When I asked the BPN community, there were no responses whatsoever. I suspect that their orthodontists are either young and relatively inexperienced or established and without a loyal following. --worried about orthodontists, but glad I have Costco Delta Dental nonetheless


2007 - 2009 Recommendations


Good and Inexpensive Dental Insurance

Feb 2009

I have been laid off and need to find dental insurance for myself and my family. Can anyone recommend a good and reasonable priced dental insurance for a family or small business. Thanks Maisy


Maisy, if you need good dental insurance, try Lifelong Dental. Their staff are very friendly and most of the dentists there are very good and super nice. Good luck with your search :-) Patricia


Delta Dental has done it for our family for years. Seem to be the plan more school districts use. Subsidized by BUSD, their Delta Dental -- PPO Pland was $96.96/mo. and the DMO Plan was $32.85 per month. Now that I am on COBRA, the $32.85 dental is $83.14. kl


2004 - 2006 Recommendations


Affordable Individual Dental Insurance

May 2005

My husband's company does not provide dental insurance, and so I am about to embark on looking for dental insurance, at least for me, and ideally for my family. I am aware that dental insurance is going to be terribly expensive. I'm hoping that someone has done the research for dental insurance recently, and can point me in the right direction. Thank you!


Nationwide has great insurance rates. They are one of the largest insurance carriers but b/c they don't have a large advertising budget, they are far less costly. They offer Delta Dental through their program but you do have to join the Farmer's Bureau to qualify......


You can get an individual HMO dental plan through Delta Dental (and administered through their affiliate PMI Dental Health Plan). You can sign up on their web site at www.deltadentalca.org and link to Individual Plans from PMI Dental Health Plan. Jeannine