Health Plans Expected to Include Dental Benefits

Dentistry Today


According to a survey by West Monroe Partners, 96% of insurance executives believe dental benefits already are being embedded or will be embedded into medical plans. Currently, 99% of commercial dental insurance plans are purchased through standalone dental insurers.

Competitive margins and profitability, relative benefit simplicity, customer retention, and the increasing proof of correlation between oral health and overall health are driving more health insurers to experiment and invest in adding dental benefits to their plans, the company says.

Convergence opportunities exist between health and dental insurers, especially as both face significant technical investments necessary to modernize core platforms and address consumer demands, West Monroe Partners reports.

As a result, standalone dental insurance plans are attractive targets for health plans, either for acquisition or partnership, the company says. In fact, 100% of surveyed health plan executives whose companies don’t offer dental benefits say they plan to do so in the near future.

The survey points toward a gap between market realities and leadership action on the dental side of the industry, West Monroe Partners says. While 47% of dental insurance executives feel convergence is a threat to their business, 38% call it a threat and an opportunity, and 13% say it would be “positive” for their business.

However, 24% plan to proceed with “business as usual,” while 60% of all respondents, both dental and health insurance executives, think the percentage of standalone dental plans will significantly decrease in the next three to five years.

A report based on the survey’s results, “Signature Research: The Fate of Standalone Dental,” further examined three scenarios for the future of standalone dental plans: 

  • Dental is absorbed into overall health insurance, with one product and one shared premium
  • Dental plans are brought on as partners to health insurance, with two products and shared or separate premiums
  • Dental plans diversify, expanding into other ancillary coverage such as life and short-term disability to remain standalone

Additionally, 60% of the overall respondents think the percentage of standalone dental plans will significantly decrease in the next three to five years, while 43% of plans will explore offering ancillary products like vision, hearing, life, and disability.

“For standalone dental plans, winter is here,” said Will Hinde, managing director of West Monroe’s Healthcare & Life Sciences practice and co-author of the report. “It’s absolutely essential that dental plans prepare to be attractive partners and understand that standing still or alone is no longer an option for plans that want to thrive in the future.” 

Furthermore, dental plan and health plan executives agree that health plans have a clear or significant advantage over standalone dental insurers in a bundled scenario: 82% of dental plan executives said so, while 80% of health plan executives said so.

Finally, the survey respondents cited the three biggest factors that will drive the embedding of dental insurance into health insurance:

  • Better technology and systems that facilitate a holistic view of covered lives
  • Government actions such as changes to Medicaid and Medicare
  • The convergence of overall health and oral health

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