Slightly Fewer Americans Have Dental Insurance than a Year Ago, but More Seniors Are Covered: Insights from NADP’s Dental Benefits Enrollment Report

By Mike Adelberg, NADP Executive Director

Earlier this month, NADP published its annual Dental Benefits Enrollment report. The annual report is the nation’s most comprehensive estimate of dental insurance participation and the flagship product of NADP’s ongoing research program.

It is worth noting that the report documents a slight drop in dental insurance coverage in 2023. NADP estimates that 87 percent of the U.S. population has dental insurance in 2023—1 percent less than in 2022. The drop is mostly attributable to the Medicaid redetermination process implemented at the conclusion of the COVID Public Health Emergency. Across the states, redetermination processes resulted in an 8.8% decrease in Medicaid eligibility. Dental coverage leads to better oral health, and better oral health leads to better overall health. However, this decline in coverage likely removes some double counting of coverage as many individuals may have transitioned to private coverage while maintaining their Medicaid eligibility.

While fewer people were eligible for dental coverage through Medicaid, the continued growth of Medicare Advantage resulted in more seniors (and disabled people under 65) receiving dental coverage through Medicare Advantage plans. The vast majority of Medicare Advantage plans choose to offer members dental coverage as a supplemental benefit. Market research on the senior population repeatedly demonstrates that dental coverage drives more plan selections than any other supplemental benefit.

NADP estimates that, in 2023, 25.5 million Medicare beneficiaries received credible dental benefits through Medicare Advantage. NADP’s figure is slightly smaller than estimates gleaned from the Centers for Medicare and Medicaid Services’ data because we skim out plans that offer minimal benefits, such as limited preventive-care-only coverage. NADP also detected an increase in dental coverage via Medicare Supplemental (Medigap) insurance where an increasing number of states permit dental coverage to be sold in concert with “Med Supp.” For the first time NADP estimates that more than a million Medicare beneficiaries with Medicare Supplemental insurance have purchased affiliated dental plans, although much of this estimate can be attributed to better data from plans participating in the survey.

Half of all Americans receive dental benefits through their employers. In this sector, overall dental enrollment decreased by 1 percent. This is likely due to macro-economic factors such as a slight rise in the unemployment rate. DPPOs, which offer consumers greater provider choice than restricted-network DHMOs, continue as the dominant commercial dental product. 89 percent of Americans who received dental insurance through their employers are served by DPPOs. For 43 percent of commercially insured Americans with dental coverage, the purchase of dental is voluntary and unsubsidized.

Only 44 percent of group dental benefits are purchased through self-insured employers, continuing a decade-long gradual decline. Most employer coverage, 83 percent, continues to be offered through large group employers. Coverage “persistency” (when an employer offers the same dental plan in consecutive years) continues to hover near 90 percent.

Less than 5 percent of individuals with commercial dental coverage purchase those policies individually—often through the insurance “Marketplaces” established by the Affordable Care Act. Less than two percent of commercial dental benefits are purchased through integrated medical-dental plans.

I congratulate NADP’s Research Commission and Jerry Berggren, NADP’s Research Director, for compiling and publishing another timely and important report. And I extend sincere thanks to the 29 dental insurance carriers that supplied the data that undergirds this study.

The Dental Benefits Enrollment report is only one of NADP’s regular reports. NADP also publishes annual or bi-annual reports that examine consumer experience, plan design, utilization, and other important dental benefit information.

To access the full Dental Benefits Enrollment report, the one-page summary or to learn more about other NADP reports, visit knowledge.nadp.org.