Cypress Dental Insurance is a well-established provider of dental and vision insurance plans based in Stockton, California. With over 40 years of experience, Cypress Dental has served thousands of individuals and families, focusing on delivering reliable and affordable ancillary benefits such as dental, vision, life, and disability insurance. Their commitment is to provide excellent customer service and accountability to clients and brokers alike.
Types of Cypress Dental Insurance Plans
Cypress Dental offers a variety of dental insurance plans tailored to meet the needs of different groups and individuals:
Preferred Provider Organization (PPO) Plans: These plans allow members to choose dentists within the Cypress Dental PPO network or go out-of-network, sharing costs with the insurance. In-network providers charge reduced contracted rates, lowering out-of-pocket expenses. PPO plans have a Calendar Year Maximum (CYM), which limits the total amount the plan will pay annually, excluding orthodontics.
Dental Health Maintenance Organization (DHMO) Plans: DHMO plans keep out-of-pocket costs low without requiring members to reach a CYM. Members must use network dentists to maximize benefits.
Cypress Hybrid Plan: This exclusive plan combines the advantages of PPO and DHMO plans. Members can switch monthly between PPO and DHMO coverage to optimize savings depending on their dental care needs.
Maximum Allowable Charge (MAC) Plans: These plans pay providers a contracted fee for services whether in or out-of-network, which is typically lower than PPO fees. Staying in-network is crucial to avoid higher costs. MAC plans usually have lower premiums and suit employers with employees who mostly use in-network providers.
Dual Option Plans: These plans offer members a choice between high and low coverage options, allowing employees to select plans that fit their dental needs and budgets. Formats include High/Low PPO, DHMO/PPO, DHMO/MAC, and High/Low MAC.
Voluntary Plans: These are additional options offered for employees who want to purchase dental coverage voluntarily.
For individuals, Cypress Dental also offers dental and vision plans starting at $6.95 per month, making coverage accessible for many.
Advantages of Cypress Dental Insurance
Flexibility: The Hybrid plan allows members to switch between PPO and DHMO monthly, providing flexibility to manage costs and care preferences.
Wide Network: PPO plans offer a broad network of dentists, giving members freedom to choose providers while benefiting from negotiated rates.
Affordable Options: MAC plans and DHMO plans offer lower premiums and out-of-pocket costs, suitable for budget-conscious members.
Comprehensive Coverage: Plans cover preventive, basic, and major dental services, including exams, cleanings, fillings, root canals, crowns, bridges, and dentures.
Orthodontic Coverage: Some plans include orthodontia with specific lifetime maximums and conditions for ongoing treatments.
No Claim Forms for Some Plans: Certain plans, like those offered through Liberty Dental Plan, provide coverage without claim forms, deductibles, or annual maximum limits.
Group and Individual Plans: Cypress Dental caters to both employers and individuals, offering group plans that can be customized to company needs and affordable individual plans.
Coverage of Cypress Dental Insurance
Cypress Dental Insurance covers a range of dental procedures categorized into preventive, basic, and major services:
Preventive Services: Routine oral exams (up to 2 per year), cleanings (up to 2 per year), bitewing x-rays (up to 4 films per year), sealants for children under 16, and fluoride treatments for children under 16.
Basic Services: Full-mouth x-rays (once every 36 months), restorative fillings (limited by age and frequency), simple extractions, emergency exams, periodontal treatments such as root planing and deep cleaning, endodontics (root canals), oral surgery, and general anesthesia for surgical procedures.
Major Services: Crowns, bridges, dentures, and space maintainers for children under 16, with limits on frequency (usually one per 5 years per tooth or procedure).
Orthodontics: Coverage may be available depending on the plan, with conditions for ongoing treatments and lifetime maximums.
Limitations: Benefits for initial placement of bridges, partials, and dentures are not covered if the teeth were missing before coverage began. There are also late entrant provisions limiting coverage to preventive services for the first year if enrollment is delayed.
This comprehensive coverage helps address common dental issues, including gum inflammation and gum disease, by covering periodontal treatments like deep cleanings and root planing, which are essential for managing gum health.
Related Costs of Cypress Dental Insurance
Premiums: Individual dental and vision plans start as low as $6.95 per month, while group plans’ premiums vary based on coverage options and employer contributions.
Deductibles: PPO plans typically have deductibles around $50 for basic and major services, with a family deductible around $150 per year.
Coinsurance: Members pay a percentage of costs after deductible—commonly 0% for preventive, 20% for basic, and 50% for major services when using in-network providers.
Annual Maximums: Most plans have a Calendar Year Maximum (e.g., $1,500), which caps the total amount the plan will pay annually, excluding orthodontics.
Out-of-Network Costs: Visiting out-of-network dentists usually results in higher out-of-pocket expenses because dentists may charge fees above the plan’s negotiated rates, and members pay the difference plus coinsurance and deductible.
Orthodontic Costs: Orthodontic coverage is subject to lifetime maximums, and treatment costs may vary depending on plan specifics.
Balance Billing: In MAC plans, out-of-network providers can charge more than the contracted fee, leading to balance billing, where members pay the difference.
Advantages and Disadvantages of Cypress Dental Insurance
| Advantages | Disadvantages |
| Flexible plan options including Hybrid and Dual Option plans allow members to tailor coverage to their needs. | Some plans have annual maximum limits that may not cover extensive dental work in a year. |
| Wide network of providers with negotiated rates reduces out-of-pocket costs for in-network care. | Out-of-network care can be expensive due to balance billing and higher coinsurance. |
| Comprehensive coverage includes preventive, basic, major services, and periodontal care for gum disease management. | Orthodontic coverage is limited and may not be available on all plans. |
| Affordable premiums and deductibles make dental care accessible for individuals and groups. | Late entrants face restrictions, such as coverage limited to preventive services for the first 12 months. |
| No claim forms for some plans simplify the claims process. | Some exclusions and limitations apply, such as no coverage for missing teeth before coverage start. |
Conclusion
Cypress Dental Insurance offers a broad range of dental plans designed to meet the diverse needs of individuals and employers. Their flexible options, including PPO, DHMO, Hybrid, MAC, and Dual Option plans, provide choices that balance cost, coverage, and provider access. Coverage includes essential dental services from preventive care to major restorative procedures, with special attention to periodontal treatments that help manage gum inflammation and gum disease. While the plans come with some limitations like annual maximums and restrictions on out-of-network care, Cypress Dental’s long-standing reputation and affordable pricing make it a solid choice for dental insurance in California and beyond.
