Dental Insurance Basics
- Common dental policy types include preferred provider organizations (PPOs), dental health maintenance organizations (DHMOs), indemnity plans and direct reimbursement plan types, according to US Legal.
PPOs and DHMOs are popular group managed care policy types; these are networked-based dental plans in which insured people select providers within the insurers network. Indemnity plans are simple fee for service policies. Direct reimbursement policies involve direct employee pay to the dental provider, followed by full or partial reimbursement by the employer. - Whereas insurance products are typically purchased to protect against certain negative risks, dental insurance is unique in that it is often used for routine maintenance care like checkups, cleaning, x-rays and fluoride treatments. Dental insurers often agree to pay for semi-annual dental check ups. The provider's intention is that by supporting routine care, more expensive treatments and surgical measures become less common, according to the Consumer Guide to Dentistry.
- Aside from routine check ups, dental care includes surgical procedures like tooth removal and root canals, along with orthodontics and cosmetic dentistry. Common surgeries are covered by broad dental policies. Orthodontics, like braces, are sometimes covered for people under 19. Cosmetic dentistry procedures are usually not covered by insurers as they are considered unnecessary, according to the Cosmetic Guide to Dentistry.
- Dental policy premiums often cost under $100 for group plans through an employer. The premium cost varies by the benefits in the policy and plan types. Along with premiums, dental policies commonly function with co-insurance percentages. Insurers typically pay 50 to 80 percent of covered services, while the insured pays a 20 to 50 percent co-insurance, according to the site Insurance Company.com.
- Dental coverage can be confusing. It is a good idea to confirm benefits for routine procedures and surgeries prior to the event. Dentists often offer estimates prior to treatment by reviewing your policy benefits. Be aware of policy exclusions on treatment and care. Insurance Company.com advises that you know the benefit maximums for each area of protection on your policy.