Dental Plan Comparison Tool

This tool is designed to help you compare dental plans that are offered through NY State of Health.

If you plan to enroll only your children in dental benefits, select the Pediatric Dental tab below.

If only adults or both adults and children need dental coverage, you can either shop for stand-alone family dental plans (select the Family Dental tab below) or you can see if there are Qualified Health Plans that include a family dental benefit in your county (select the QHP with Dental tab below).

Next, select the County in which you reside. Then, enter the number of children you wish to enroll in a Pediatric Dental plan OR who you wish to enroll in a Family Dental plan or in a QHP with family dental benefits. (Please note – only policies that indicate “Family Dental” would include dental benefits for adults).

Make sure to hover over the “Question Marks” for help.

Issuer Name Plan Name New for 2021 Plan Type Waiting Periods Referrals Required to See a Specialist Specialists Requiring Referrals Annual Benefit Maximum Out of Network Coverage? County Children Amount Premium Brochure Deductible Pediatric Individual - Children MOOP Pediatric Individual - Children Deductible Pediatric 2+ Children MOOP Pediatric 2+ Children Dental Check-Up - Children Basic Dental Care - Children Major Dental Care - Children Orthodontia - Children Deductible Pediatric Individual - Children MOOP Pediatric Individual - Children Deductible Pediatric 2+ Children MOOP Pediatric 2+ Children Dental Check-Up - Children Basic Dental Care - Children Major Dental Care - Children Orthodontia - Children Out of Country Coverage Out of Country Coverage Description Out of Service Area Coverage Out of Service Area Coverage Description National Network Network Name Network URL
Empire Dental Pediatric, ST, OON, Prime, Pediatric Dental N None N None None Y Albany
1
$
24.85
$
$25
$350
$25 per person
$350 per person / $700 per group
25% after deductible
25% after deductible
50% after deductible
50% after deductible
$25
N/A
$25 per person
N/A
25% after deductible
25% after deductible
50% after deductible
50% after deductible
Y
Out of Country covered services are reimbursed as out-of-network benefits.
Y
If a member does not use a network dentist, services will be reimbursed at the out-of-network level.
Y
Dental Prime
Solstice Health Insurance Company EssentialSmile 111 ST INN Pediatric N None Y Referrals are required to see any provider other than your primary care dentist None N Albany
1
$
9.82
$
$50
$350
$50 per child
$350 per person / $700 per group
$0 - $125 copayments after deductible
$0 - $100 copayments after deductible
$20 - $350 copayments after deductible
$350 copayments after deductible
N/A
N/A
N/A
N/A
Not covered
Not covered
Not covered
Not covered
N
N/A
N
N/A
N
EssentialSmile EPO
Healthplex Insurance Company, Inc ST, INN, DP, Pediatric Dental, Healthplex Network N None N None None N Albany
1
$
18.95
$
$75
$350
$75 per child
$350 per person / $700 per group
$0 after deductible
$0
$0 after deductible
$0 after deductible
N/A
N/A
N/A
N/A
Not covered
Not covered
Not covered
Not covered
N
N/A
N
N/A
N
Healthplex Exchange

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