Penn Dental Insurance Plans for Pennsylvania Residents Explained

Pennsylvania residents have several dental insurance options to consider.

The Pennsylvania Dental Association (PDA) offers a group dental insurance plan for its members, which includes discounts on dental services.

To be eligible for the PDA group plan, you must be a member of the association, which costs around $200 per year.

Penn Dental Partners offers a range of individual and group dental insurance plans, including a plan that covers 100% of preventive care services.

These plans are designed to be affordable and accessible to residents of Pennsylvania.

You can choose between an individual dental insurance plan and a DHMO-type plan in PA.

Both plans have their pros and cons, but it ultimately comes down to your specific needs and preferences.

If you want the freedom to see any dentist, a PPO plan might be the way to go. You'll have to pay for out-of-network care, but your plan will still help cover some of the costs.

DHMO-type plans, on the other hand, have fixed prices for procedures, known as copays. These premiums tend to be lower, but you'll only enjoy coverage at your chosen DeltaCare USA dentist.

Here's a comparison of the two plans:

Keep in mind that prices vary by plan type, location, and number of dependents.

It's also worth noting that PPO plans have waiting periods for major services, whereas DHMO-type plans do not.

You can get low, negotiated rates with individual PPO plans to help limit out-of-pocket costs for dental care.

Good dental health is essential to your overall well-being, and choosing a plan that supports your needs can help maintain your oral health and quality of life.

Three out of four U.S. dentists are in combined networks, making it likely you'll find a dentist you can trust for routine visits or specialized services.

If your insurance doesn't cover a procedure you need, consider replacing it with a new plan that covers the services you need and doesn't delay access to the needed procedure through a "waiting period."

Here are some key things to consider when replacing your plan:

Braces and cosmetic dental procedures can be expensive, so it's great to know that some dental plans cover them. We offer Pennsylvania dental plans that cover many procedures, including braces.

Not all dental plans are created equal, so it's worth shopping around to find one that suits your needs. Some plans offered by employers may have different benefits than plans available directly from Delta Dental.

Braces are just one example of a covered procedure - dentures are also included. Cosmetic procedures like teeth whitening are covered as well.

However, it's essential to remember that not all plans cover all procedures, so it's crucial to review your plan carefully.

Prior authorization of major procedures is a best practice to help you understand the costs involved. It's recommended by your carrier for treatments costing more than $300.00.

For potentially covered treatments, obtaining prior authorization from your carrier is a good idea. This way, you'll have a clearer estimate of the costs before treatment.

Even if your insurance carrier indicates a procedure is covered, it's still subject to review. Significant procedures could be delayed or denied due to your carrier's review process.

Obtaining prior authorization can save you from unexpected costs. It's also a good idea to familiarize yourself with your insurance coverage to avoid any surprises.

If your insurance doesn't cover a procedure you need, consider replacing it with a new plan. Just make sure the new plan covers the services you need and doesn't delay your access to the procedure.

Deductibles and out-of-pocket costs can be a big concern when it comes to dental coverage.

Some plans have no deductible at all, but the average deductible is $56.41 per enrollee. For those plans that do charge a deductible, slightly more than half charge a single individual $50 annually.

Family deductibles are more expensive, with some plans charging a $50 annual deductible for each family member enrolled. Other plans cap the maximum annual deductible for a family, which can range from as low as $75 to as high as $450.

It's worth noting that some plans waive deductibles for certain preventive services, which can be a big help.

Many plans also have a cap on what the dental plan will pay annually toward enrollee dental expenses, with the lowest caps being $500 and the highest cap being $5,000. Two HMO plans and one dental discount card have no cap at all.

Here's a breakdown of some plans with notable caps:

You can find a Delta Dental network dentist in your area by using their Find a dentist tool, which allows you to search by network, dentist or practice name, specialty, languages spoken, gender, office hours, and whether they're accepting new patients.

To save the most, choose the Delta Dental PPO network for Delta Dental PPO plans and the DeltaCare USA network for DeltaCare USA plans.

If you're looking for free or reduced-cost dental clinics, you can use an online tool that allows you to select your county and see a list of clinics that offer sliding scale fees based on ability to pay.

You can find a Delta Dental network dentist in your area by using their Find a dentist tool. Select the network for your preferred plan, either Delta Dental PPO or DeltaCare USA.

To save the most, choose the Delta Dental PPO network for Delta Dental PPO plans and the DeltaCare USA network for DeltaCare USA plans. You can also search by dentist or practice name, specialty, languages spoken, gender, office hours, and which dentists are accepting new patients.

The Delta Dental PPO plan allows you to choose any dentist, while the Premium plan also offers this flexibility. Both plans cover diagnostic and preventive services, such as cleanings, exams, and x-rays, at 100% coverage.

If you're looking for a more affordable option, the Basic plan starts at $20.99/month and offers 100% coverage for diagnostic and preventive services. The Premium plan starts at $17.32/month and also offers 100% coverage for these services, but with additional perks.

Here are some key differences between the Basic and Premium plans:

Remember to check the waiting periods for each plan, which can range from 30 days to 12 months, depending on the service.

If you're struggling to afford dental care, there's a helpful online tool that can connect you with free or reduced-cost clinics in your area. This tool enables you to select your county and see a list of dental clinics that offer free or sliding scale services based on your ability to pay.

Pennsylvania residents can use this tool to find affordable dental care options.

Penn dental insurance costs can vary depending on the type of plan and provider. A recent analysis of 39 dental plans offered in Pennsylvania found that 76% were Preferred Provider Organizations (PPO dental insurance), while 5% were Health Maintenance Organizations (HMO dental insurance).

Monthly premiums across all 39 Pennsylvania plans examined averaged $39.79 a month. The least expensive offering, the Select Plan Basic, a HMO from Dominion National, had a monthly premium of $7.89 a month, while the most expensive plan, the Humana Extend 5000 Dental PPO+Vision, had a monthly premium of $94.99.

For adults purchasing stand-alone dental coverage through the exchange in Pennsylvania, premiums in 2025 range from about $4 to $38 per month. This price range can help you estimate your dental insurance costs and make an informed decision about your coverage.

At Penn Dental Medicine, you'll receive up-front fee estimates at every visit. They'll advise you about the recommended treatment and its estimated cost, as well as any alternative treatments.

You'll be asked to sign the treatment plan once you understand and accept it. The fee charged at the time any service or procedure starts will be the fee currently in effect.

If your treatment plan requires a change due to changes in your oral condition or patient neglect, the estimated fee may no longer be honored. The same applies if you don't follow the treatment schedule as your student doctor directs.

Here are the reasons why estimated fees may not be honored:

At each visit, Penn Dental Medicine will advise you of each succeeding procedure’s costs to prepare you for subsequent charges.

For certain services, prepayment is required before treatment can begin. Two-thirds of the fee for services like crowns, bridges, and dentures must be paid upfront to submit the case to the laboratory.

This prepayment rule doesn't apply to all services, however. For implant services and periodontal surgical procedures, you must pay the full fee before treatment starts.

If you're getting a crown, bridge, or denture, be prepared to pay 2/3 of the fee before the lab can make the final prosthesis.

Dental insurance can be a significant expense, but it's essential for maintaining good oral health. In Pennsylvania, the average monthly premium for dental insurance is $39.79.

You can expect to pay anywhere from $4 to $38 per month if you purchase stand-alone dental coverage through the exchange. This range is based on data from 2025.

Penn Dental Medicine estimates treatment costs upfront, so you'll know exactly what to expect. They review their fees annually, but you'll be charged the current fee at the time of service.

Some dental insurance plans in Pennsylvania can be quite affordable, with the least expensive option costing just $7.89 per month. This plan is the Select Plan Basic, a HMO from Dominion National.

The most expensive dental plan in the study had a monthly premium of $94.99, which includes additional vision coverage. This plan is the Humana Extend 5000 Dental PPO+Vision dental plan.

Here's a breakdown of the types of dental insurance plans available in Pennsylvania: