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Dental Insurance in California: Scope, Structure, and Availability

September 1, 2009

External Publication

Author: Nadereh Pourat, PhD

Although structured similarly to health insurance, dental insurance is often more limited in scope and availability. People without dental coverage typically seek dental care less often and may suffer poor dental health as a result.

This issue brief examines the basic structure of dental insurance to illustrate how it enables Californians' access to dental care. Topics include:

  • Rates of coverage, cost-sharing, and scope of benefits for employer-sponsored, privately purchased, and public dental plans;

  • Types of coverage, including dental HMOs, dental PPOs, indemnity plans, and other options;
  • Dental insurance premiums and their effect on people's willingness to accept coverage.
The analysis finds that private dental coverage is dominated by PPO and indemnity plans, while public plans employ extensive authorization requirements to control service use. It concludes that coverage limitations and higher levels of cost-sharing are likely to increase disparities in access to oral health services between Californians of lower socioeconomic status and those with higher incomes.

The brief was supported by the California HealthCare Foundation.

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