New Jersey Dental Insurance Options for Individuals and Families

New Jersey offers several dental insurance options for individuals and families. You can choose from a variety of plans that cater to different needs and budgets.

Many New Jersey residents prefer individual plans, which can be purchased through the state's health insurance marketplace, Get Covered NJ. These plans often have lower premiums but may come with higher out-of-pocket costs.

The state also offers family plans, which can be more expensive but provide more comprehensive coverage. Some family plans may include coverage for children's orthodontic care, which can be a significant cost savings for families with kids.

In addition to individual and family plans, New Jersey also offers group dental insurance plans for businesses and organizations. These plans can be customized to meet the specific needs of the group and may offer discounts for large groups.

In New Jersey, you can purchase stand-alone individual and family dental plans through the state-run health insurance exchange at GetCoveredNJ. These plans are certified by the state and must be purchased separately from medical plans.

Delta Dental of New Jersey, Inc. is one of the six insurers that offers stand-alone dental coverage through the New Jersey marketplace.

Dentegra Insurance Company, Dominion Dental Services, Inc., Guardian, Horizon Blue Cross Blue Shield of New Jersey, and UnitedHealthcare Insurance Company are also among the insurers that offer stand-alone individual and family dental coverage in New Jersey.

You can purchase these exchange-certified stand-alone dental plans through Get Covered NJ during open enrollment (November 1 to January 31) or during a special enrollment period triggered by a qualifying life event.

Here are the six insurers that offer stand-alone individual and family dental coverage through the New Jersey marketplace:

In New Jersey, dental insurance costs can range from $9 to $48 per month for adults purchasing stand-alone coverage through the exchange.

The average cost of dental insurance in New Jersey is $24 per month, or about $282 per year, but the final price depends on your choice of dental benefits, tobacco usage, and other factors.

Premium tax credits can offset the cost of pediatric dental coverage, but this depends on the health plan and your eligibility.

NJ FamilyCare provides free or low-cost dental coverage to qualifying residents, including uninsured children and pregnant women with income above the Medicaid eligibility limits.

Dental insurance plans in New Jersey often have annual maximums, which can be as low as $1,500, leaving you responsible for all costs over that amount.

Waiting periods for specific treatments can range from six to twelve months, and major procedures may only be covered at a portion of the cost initially.

In New Jersey, the cost of dental insurance can vary significantly, ranging from about $9 to $48 per month for adults who purchase stand-alone coverage.

The average cost of dental insurance in New Jersey is $24 per month, or about $282 per year.

Your location within New Jersey can impact the cost of your dental insurance, as different areas may have different rates.

Insurance providers also consider your tobacco usage, the number of people covered on your policy, and the level of coverage you choose when determining your premium.

The cost of dental insurance can also be influenced by your overall dental health, with those who have good dental hygiene potentially paying less.

A policy's annual maximum, or the most it will pay out for coverage in a year, is another factor that can impact the cost of your dental insurance.

Lower annual maximums can result in higher out-of-pocket expenses for policyholders.

Annual Maximums Limitations can catch you off guard, especially if you have a dental emergency. Every dental insurance plan has a yearly maximum payout limit, and for many people, that amount is surprisingly low.

If your plan has a yearly cap of less than $1,500, you're responsible for all costs over that amount. It's easy to reach your maximum if you require a crown or root canal surgery.

In New Jersey, dental insurance doesn't cover aesthetic dentistry, which means treatments like teeth whitening and veneers are not covered.

These cosmetic procedures are considered medically unnecessary, so insurance won't pay for them.

Aesthetic dentistry is all about improving a person's appearance, not fixing damaged teeth.

New Jersey offers a range of dental plans that can help you cover essential dental care. GetCoveredNJ has certified individual and family dental plans from six insurers, giving you options to choose from.

You can expect to pay a portion of the cost for major dental services like crowns, fillings, root canals, and extractions, even with a dental plan that starts right away. In fact, you'll likely only receive around 20% coverage for these services in the first six to twelve months.

Dental insurance plans in New Jersey often start on the 1st day of the following month from when you enroll, which means it could be several weeks before basic services are covered. This is a good time to consider alternative options like a dental discount plan.

NJ FamilyCare, which includes New Jersey's CHIP, provides free or low-cost dental coverage to qualifying residents of any age, including uninsured children and pregnant women with income above the eligibility limits for Medicaid. This can be a game-changer for those who need extensive dental services but can't afford them otherwise.

In New Jersey, you have several options when it comes to dental insurance plans. The most popular types of dental insurance coverage are DHMO and PPO dental plans.

A PPO plan, or Preferred Provider Organization, is often the most expensive choice, but it gives you more flexibility to choose your dentist and specialist care without needing a referral.

Delta Dental of New Jersey offers multiple plans, including PPO and HMO options, with extensive networks of participating dentists and various levels of coverage to suit your needs.

A PPO plan, or Preferred Provider Organization, is typically the most expensive choice.

It comes with more choice and the opportunity to pick a dentist you prefer, giving you flexibility in your dental care.

This plan allows you to see any dentist you want, but you'll pay more for out-of-network care.

You won't need to see your regular dentist for a referral if you require specialist care, which can be a big advantage.

A PPO plan's costs can range from $50 to $100 per month or more, depending on the level of coverage and services included.

This can be a significant expense, especially for those with limited budgets.

You can expect to pay more for a PPO plan, but it may be worth it if you value having a choice in your dental care providers.

Stand-alone pediatric plans on the ACA exchange are available through the New Jersey marketplace, Get Covered NJ. These plans comply with the ACA's pediatric dental coverage rules.

If you purchase a stand-alone pediatric dental plan through Get Covered NJ, out-of-pocket costs for pediatric dental care won't be more than $400 per child in 2024, or $800 for all the children on a family's plan. For 2025, these limits will increase to $425 and $850, respectively.

There is no cap on medically necessary pediatric dental benefits, so you won't have to worry about exceeding a certain limit for essential care.