Dental Insurance Hawaii Guide for Individuals and Families

Dental insurance in Hawaii can be a bit tricky to navigate, but don't worry, I've got you covered.

In Hawaii, dental insurance is not mandatory, but it's highly recommended to protect your wallet and your teeth. Most dental insurance plans in Hawaii cover a wide range of services, including routine cleanings, fillings, crowns, and even orthodontic treatment.

If you're an individual or a family looking for dental insurance in Hawaii, there are several options to consider. You can purchase a plan directly from an insurance company, or you can buy a plan through your employer if you have one. Some popular dental insurance companies in Hawaii include Delta Dental and UnitedHealthcare.

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There are three main types of dental insurance plans in Hawaii: Preferred Provider Organization (PPO) plans, Dental Health Maintenance Organization (DHMO) plans, and Dental Discount plans.

PPO plans allow you to see any dentist you want, but you'll pay more out-of-pocket for services from non-network providers.

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DHMO plans require you to see a specific network of dentists, but you'll pay lower premiums and copays.

Dental Discount plans are not insurance, but rather a membership program that offers discounted rates on dental services from participating providers.

Most dental plans in Hawaii offer a 100-80-50 coverage scale, which means your insurance pays for 100% of preventive care, 80% of basic procedures, and 50% of major procedures.

Here's a breakdown of the 100-80-50 coverage scale:

Keep in mind that not all plans follow this 100-80-50 coverage scale, so be sure to check your policy carefully to see what's covered and how much you'll pay.

In Hawaii, the cost of dental insurance can vary greatly depending on several factors, including your age, location, and the type of coverage you need. For adults purchasing stand-alone dental coverage through the exchange, premiums can range from about $18 to $46 per month.

The average cost of dental insurance for an adult in Hawaii is around $350 per year. However, this can increase to over $840 per year for individuals in their 20s. The cost of living in Hawaii is higher than anywhere else in the country, which contributes to the higher cost of dental insurance.

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A plan with a low annual maximum and high deductible typically has a lower monthly premium, but you'll likely have a higher annual maximum, lower deductible, and more coverage if you pay a higher monthly cost. You may also be able to lower your dental insurance costs through discounts, such as combined vision and dental insurance coverage, military discounts, or senior discounts.

Here are some estimated monthly premium ranges for dental insurance in Hawaii:

Keep in mind that these are just estimates, and your actual premium may vary depending on your specific circumstances. It's always a good idea to shop around and compare different plans to find the best option for your needs and budget.

In Hawaii, you can find dental insurance through the health insurance marketplace or by purchasing a stand-alone plan from a private provider. Three insurers offer stand-alone individual/family dental coverage through the health insurance marketplace in Hawaii: BEST Life, Hawaii Dental Service, and HMSA.

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You can purchase these plans through HealthCare.gov during open enrollment or during a special enrollment period triggered by a qualifying life event. Exchange-certified stand-alone dental plans are compliant with the ACA's rules for pediatric dental coverage.

UnitedHealthcare is the largest health insurance provider network in Hawaii and offers dental insurance with affordable plan options. Many of their plans in Hawaii offer unmatched annual maximums at a great price, with some plans carrying an annual benefit maximum of $3,000.

A Health Maintenance Organization, or HMO, is a type of dental insurance plan that can help you save money on premiums.

You won't have to worry about deductibles or annual maximums with a DHMO plan, but you will have to choose a primary dentist or oral health facility. This can be a good option if you have a regular dentist you visit.

DHMO plans typically don't require a deductible or coinsurance, but you might have to pay a copayment for services. For example, you may have to pay $20 for a $100 service.

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A DHMO plan requires you to choose a primary in-network dentist or oral health facility, which can be a drawback. If you visit a dentist other than your primary facility, you may have to pay the entire bill yourself.

Delta Dental is one of the many providers that offer DHMO plans. They cover millions of families across the country and offer several basic plan options.

Here are some of the top dental insurance providers that offer HMO plans:

UnitedHealthcare is the largest health insurance provider network, offering a wide range of affordable plan options.

Many of their plans in Hawaii offer unmatched annual maximums at a great price. Some plans carry an annual benefit maximum of $3,000, which is twice the normal amount of $1,500.

In the Hawaii marketplace, there are three insurers that offer stand-alone individual/family dental coverage in 2025.

These insurers are BEST Life, Hawaii Dental Service, and HMSA.

You can purchase these dental plans through HealthCare.gov during open enrollment, which takes place from November 1 to January 15, or during a special enrollment period triggered by a qualifying life event.

These plans are exchange-certified and comply with the ACA's rules for pediatric dental coverage.

Here are the insurers that offer dental coverage through the Hawaii marketplace:

In Hawaii, you can purchase stand-alone dental coverage through the health insurance marketplace. This coverage can be purchased through HealthCare.gov during open enrollment or a special enrollment period.

Three insurers offer stand-alone individual/family dental coverage in Hawaii: BEST Life, Hawaii Dental Service, and HMSA. These plans are compliant with the ACA's rules for pediatric dental coverage.

If you're looking for a more cost-effective option, consider a Dental HMO (DHMO) plan. With a DHMO, you pay less in premiums, but you must use dentists within the plan's provider network.

A HMO Plan can be a cost-effective option, but you'll need to use dentists in the plan's provider network. You'll pay less on premiums, but you'll have to stick with in-network dentists.

Using an in-network dentist can save you money, so it's a good idea to check if your dentist is already part of the plan's network.

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A PPO Plan is the most expensive choice among insurance options.

It offers more choice and flexibility compared to other plans.

You get to pick a dentist you prefer, giving you more control over your care.

If you need specialist care, you don't need a referral from your regular dentist, making it easier to get the care you need.

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In Hawaii, stand-alone pediatric dental plans are the only way to obtain pediatric dental benefits through the exchange/Marketplace.

These plans are ACA-compliant, which means they meet the requirements for pediatric dental coverage.

All of the stand-alone dental plans available through the Marketplace will comply with the ACA's pediatric dental coverage rules.

Out-of-pocket costs for pediatric dental care will not exceed $400 per child in 2024, or $800 for all the children on a family's plan.

For 2025, these out-of-pocket maximums will increase to $425 and $850, respectively.

The specific coverage requirements for pediatric dental care are guided by Hawaii's essential health benefits benchmark plan.

The benchmark plan includes coverage for both basic and major dental services for children.

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