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Dental Insurance

 

Dental insurance is insurance that pays a portion of the costs for dental work. You can gain dental insurance various ways, including by yourself, through your employer, a local licensed insurance agent, a loan company, or an online website that is licensed to sell dental insurance products.

There are several types of individual, family and group dental insurance plans available through the sources listed above. There is also a wide range of coverage options such as free cleanings and paying per person instead of paying for the actual treatment that was provided. Unlike medical insurance that comes with standard, annual limits, deductibles, and co-pays, dental insurance limits and such are determined by individual insurance companies as filed with the department of insurance. Also, when compared to medical insurance, dental insurance plans usually offer less benefits.

So what type of dental insurance plans are available? Let’s go over that now.

Types of Dental Insurance Plans

There are eight different types of dental insurance plans, however each are designed to help with the costs of dental care. Plans vary based on limitations on the number of dental visits, radiographs, and treatments that are covered. Some services are excluded and some plans may only reimburse patients when they choose the least expensive method of treatment. Some plans do not cover pre-existing conditions.

Here is a brief description of the seven types of dental insurance plans available:

PPO Preferred Provider Organization- PPO dental plans offer their patients a small list of dentists who agree to provide dental care at a reduced cost.

Direct Reimbursement Plan - This dental plan lets employers reimburse their employees directly for dental services they receive.

Indemnity Plan – This plan allows you to choose your own individual or family dentist and the insurance company pays the dental office on a traditional fee-for-service basis. The patient (in some cases the employer) pays a monthly premium to the insurance company, who then reimburses them for money spent. You usually have an annual limit, but your dental visit is at a flat fee.

Capitation Plan - This plan basically means the dentist will get paid, regardless if any dental care was received. He or she is paid on a per capita (per person) basis instead of being paid for actual services.

Self-Insurance Plan – These plans are very similar to indemnity plans. However, you are generally not allowed to choose your dentist.

Closed Panel Plan - This plan limits you to using one of only a few dentists, as well as a specific group of facilities.

Dental Care Service Plan - This plan consists of a group of dentists who formed a non-profit organization to provide dental services at low, set fees.

DMHO (Dental Health Maintenance Organization) – This plan is very similar to a capitation plan, where the dentist is paid on a ‘per person’ basis instead of services rendered.

It’s important to remember that dental insurance differs from medical insurance in many ways, even when they are together on one plan.

Learn more about dental insurance:

Affording Dental Insurance

Dental insurance can be affordable. This article describes the different options and alternatives available to you through various sources.

Discount Dental Plans

Discount dental plans are designed for individuals, families and groups who want to save money on their dental care needs. Generally, there is a network of participating dentists and dental specialists for members to choose from.

No Dental Insurance: Is That Bad?

Learn about the options available to you if you do not have dental insurance. These options include loans, coupons, discounts and payment plans.

Page updated September 2012

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