What is dental insurance?
Dental insurance is designed to pay a portion of the costs associated with dental care. Dental offices generally work from a fee schedule — a list of prices for the services and procedures they offer — and your plan determines how much of that schedule it will cover.
Typical types of dental insurance
Indemnity plan
Helpful when you want to stay with a dentist who does not participate in a network. The carrier generally pays the dentist a percentage of your services according to the policy purchased. Review the co-payment requirements, waiting periods, stated deductible, annual limitations and the graduated percentage scales based on procedure type and how long you have owned the policy.
Dental Health Managed Organization (DHMO)
When a dentist contracts with a carrier, they agree to accept a fee schedule and give customers a reduced cost as an in-network provider. Many DHMO plans have little or no waiting period and no annual maximum benefit limitation, and cover major work near the start of the policy period. Some plans include free semi-annual preventative treatment; fillings, crowns, implants and dentures may carry various limitations.
Participating Provider Network (PPO)
Depending on the specific plan, a PPO works similarly to a DHMO while using an in-network facility, but also allows you to use an out-of-network or non-participating provider. Any difference in fees becomes the patient’s responsibility unless the policy specifies otherwise. Once an annual maximum benefit is exhausted, additional treatment may become the patient’s responsibility until the maximum reissues — as a calendar year, a company fiscal year, or from the date of enrollment.
Talk to us about the right dental insurance for you.