Dental benefits are more effective when they connect oral healthcare with a member’s broader health needs. A coordinated strategy can combine dental networks, medical referrals, benefits administration, preventive care, and member support.
The following six organizations offer different capabilities that health plans may consider when developing a whole-person approach. They are complementary examples, not a ranking of providers.
1. Delta Dental
Health plans can explore dental benefits solutions for health plan partners from Delta Dental for supplemental dental coverage across Medicare Advantage, Medicaid, Marketplace, and commercial plans.
Delta Dental reports serving more than 78 million members and providing access to over 152,000 dentists nationwide. Its network and benefits administration capabilities can help health plans manage dental coverage, member services, reporting, and implementation.
Why it matters
- Provides dental network access and benefits administration.
- Can support health plans seeking to coordinate dental coverage with existing member services and care management.
2. Epic
Epic represents the health information-sharing component of a coordinated dental strategy. Its Care Everywhere network enables participating healthcare organizations to exchange patient information across electronic health record systems.
When medical and dental providers operate separately, appropriate information-sharing and referral workflows can help teams coordinate care and follow up on identified needs.
Why it matters
- Supports interoperability between participating healthcare organizations.
- Can help medical teams coordinate referrals and follow-up when members need dental care.
3. CVS Health
CVS Health offers retail pharmacy, clinical services, and health insurance capabilities. These touchpoints may create opportunities to provide preventive health education and guide members toward appropriate services.
For example, a patient discussing oral discomfort at a clinic could be directed to their dental plan’s provider search or member support service.
Why it matters
- Provides multiple consumer healthcare touchpoints.
- May help connect members with preventive education and appropriate dental resources.
4. HealthEquity
HealthEquity supports consumer-directed benefits, including health savings accounts (HSAs) and other eligible spending arrangements. These tools can help members understand and plan for qualifying out-of-pocket healthcare expenses.
For employers offering dental coverage, clear benefits information can help employees understand how eligible expenses interact with their available accounts. Account eligibility and reimbursement rules depend on the plan and applicable tax regulations.
Why it matters
- Helps members manage eligible healthcare expenses.
- Can complement dental coverage with clear financial guidance and enrollment information.
5. American Heart Association
The American Heart Association contributes clinical education and prevention resources through its Healthy Smiles, Healthy Hearts initiative, developed in collaboration with Delta Dental. The program promotes collaboration between dental and primary care teams, including blood-pressure awareness, education, and appropriate referrals.
Dental visits can provide an additional opportunity to discuss health concerns, but dental teams do not replace primary care professionals.
Why it matters
- Encourages coordination between oral healthcare and general health services.
- Provides an example of using dental visits to support education and appropriate medical referrals.
6. Dentistry.One
Dentistry.One offers virtual oral-health consultations, coaching, care navigation, and referrals to in-person dental services. These options may help members who face scheduling, transportation, or access barriers.
Virtual support can help members understand their next steps, but examinations, imaging, and many dental treatments still require an in-person provider.
Why it matters
- Provides virtual guidance and care navigation.
- Can complement an established dental network by helping members identify suitable next steps.
Why Do Dental Benefits Belong in a Whole-Person Health Strategy?
Members may struggle to find a dentist, understand their coverage, or complete follow-up care, while everyday dental habits also influence preventive oral healthcare. Health plans can address these barriers by combining dental networks with suitable technology, clinical education, and member support.
The CMS guidance on medical-dental integration describes initiatives intended to encourage oral-health education and dental referral processes within participating medical practices.
Dental benefits work best when members can understand their coverage, find appropriate providers, and follow through with recommended care. The six organizations above represent different ways to support these goals.
How Can Health Plans Choose the Right Partners?
- Check network access: Review participating dentists, appointment availability, accessibility, and language support.
- Map the member journey: Assess provider searches, eligibility checks, referrals, claims questions, and follow-up.
- Review data capabilities: Confirm secure data exchange, reporting, privacy controls, and referral workflows.
- Measure outcomes: Monitor preventive visits, referral completion, network use, member satisfaction, and service resolution.
- Support Medicaid participation: The ADA’s Medicaid access pilot highlights approaches such as provider outreach, enrollment assistance, and streamlined administration.
A coordinated dental benefits strategy does not depend on a single organization providing every service. It brings together dental coverage, information-sharing, financial support, clinical education, and care navigation so members can access appropriate care more easily.
