How seven leading dental insurers compare on the things that actually differ — DPPO vs. DHMO plan type, the 100-80-50 coverage structure, annual maximums, waiting periods for major work, network size, and orthodontia. Qualitative only: no premiums, no ratings, no scores.
Dental plans look similar from carrier to carrier, but the details that matter are the plan type (DPPO or DHMO), how the coverage tiers are structured, whether there is a waiting period for major work, how large the dentist network is, and whether orthodontia is included. This comparison focuses on those well-established differentiators rather than prices, which vary widely by state, age, and plan tier.
Because this is a qualitative guide, we don't quote premiums, annual-maximum dollar amounts, or satisfaction scores. Instead, each carrier summary describes who the plan tends to suit and its widely-known strengths, so you can shortlist a few options and then confirm exact terms and your dentist's participation directly with the insurer.
Watch for: Plans and networks are administered by state-level member companies, so specific terms and availability vary by state.
Watch for: DHMO plan availability is limited to certain states.
Watch for: Individual-market plan availability is narrower than its group offerings and varies by state.
Watch for: Individual plans are less widely marketed than its group coverage.
Watch for: Its dental discount plans are not insurance and work differently from DPPO/DHMO coverage.
Watch for: Carryover and no-wait features depend on the specific plan you select.
Watch for: Spirit is a general agency; its plans are underwritten by partner insurers, so read the specific plan's terms.
This comparison is editorial and intentionally omits premium quotes — rates depend entirely on your specifics. Confirm coverage, availability, and current pricing directly with each carrier.
The biggest decision is the network model. A DPPO (dental preferred provider organization) lets you visit any dentist, though you save the most in-network, and you never need a referral to see a specialist. A DHMO (dental health maintenance organization) asks you to pick a primary dentist and generally costs less, but you are limited to the plan's network and may need referrals for specialty care.
DPPO plans usually carry an annual maximum and a deductible; many DHMO plans have no annual maximum and use a fixed fee schedule instead. If flexibility and dentist choice matter most, lean DPPO; if predictable low cost matters more and your dentist is already in the network, a DHMO can work well.
Most DPPO plans follow a 100-80-50 coverage structure: preventive care (cleanings, exams, routine X-rays) is covered at 100%, basic services (fillings, simple extractions) around 80%, and major work (crowns, bridges, dentures) around 50%, after any deductible. The annual maximum caps what the plan pays toward all of that in a given year.
Major services frequently carry a waiting period, often several months up to about a year, before the plan pays its share. This is where carriers differ: Guardian, Ameritas, and Spirit Dental are known for plans that waive or shorten waiting periods, and some Ameritas and Spirit plans increase the annual maximum over consecutive years of coverage.
Orthodontia is not automatic. Many plans exclude it, offer it only as an optional rider, or cover only children's braces up to a separate lifetime maximum. Guardian is often cited for stronger orthodontia options, including adult ortho on some plans. If braces are on the horizon, confirm whether ortho is included, whether it covers adults, and what the separate lifetime maximum is.
Beyond ortho, weigh the dental work you actually anticipate. If you expect major work soon, a no-waiting-period plan and a higher annual maximum matter more than the headline premium; if you mostly need cleanings and checkups, a preventive-focused plan or a DHMO may be plenty.
A DPPO lets you see any dentist, saves you the most in-network, and requires no referrals, but it has an annual maximum and a deductible. A DHMO asks you to choose a primary dentist, usually costs less, and often has no annual maximum, but you are limited to the plan's network and may need referrals for specialists.
It describes how a typical DPPO splits coverage: 100% for preventive care like cleanings and exams, about 80% for basic services like fillings, and about 50% for major work like crowns and bridges, after any deductible and up to the annual maximum. The exact percentages can vary by plan.
Guardian, Ameritas, and Spirit Dental are commonly known for offering plans that waive or shorten waiting periods, sometimes even on major services. Availability depends on the specific plan and your state, so always confirm the waiting-period terms for the exact plan you are considering.
Delta Dental operates the largest dentist network in the US, across its PPO and Premier networks. MetLife and Cigna also maintain large national networks. A bigger network raises the odds your current dentist participates, but you should still verify your dentist is in-network before enrolling.
Not always. Many plans exclude orthodontia, offer it only as an optional add-on, or cover only children's braces up to a separate lifetime maximum. Guardian is often noted for stronger orthodontia options, including adult coverage on some plans. If you need braces, confirm the ortho terms before choosing a plan.
Jennifer Walsh
Editorial Lead, Health & Medicare
This article was researched and written by the Cover Forge USA editorial team against federal sources (NAIC, CMS, FEMA, DOL, SSA, state DOIs) and standard policy forms. Bylines organize content by topic — they do not assert individual licensure. See our editorial-policy for details.
Reviewed 2026-06-14
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This site provides general educational information only and is not a substitute for professional insurance advice. All rates, data, and coverage details are estimates and may not reflect your actual premiums. Insurance availability and pricing vary by state, insurer, and individual risk factors. Always consult a licensed insurance professional in your state before making coverage decisions.