Dental Insurance << return
Many group dental plans are designed so the insured can go to any dentist of their choice. If the insured goes to a dentist that is in network, then many plans will cover the preventative visits at a 100% benefit, sometimes without a doctor visit co-payment. The basic and major services are usually covered at 80% and 50% after a deductible. Request Info.
These are the products options available through various insurance companies (refer to Partners for list of insurance companies):
- Indemnity
This is the plan where you choose your own dentist. The dental insurance plan pays the dental office (dentist) on a traditional fee-for-service basis. A monthly premium is paid by the client and/or the employer to an insurance company, which then reimburses the dental office (dentist) for the services rendered. These plans often have a pre-determined or set deductible amount which varies from plan to plan. Indemnity plans also can limit the amount of services covered within a given year and pay the dentist based on a variety of fee schedules. Some typical features of these plans:
- High deductibles before coverage begins (well-designed plans don’t apply the deductible to preventive services)
- Probationary periods on certain procedures that last up to a year
- Annual dollar limit on benefits
- Chose your own dentist
- Companies selling these plans are regulated by state insurance departments.
- DMO (Dental Maintenance Organization)
This dental plan provides dental care from a network of dentists, generally emphasizes preventive services, and covers eligible services at 100% minus a specified co-payment, and does not require the completion of claim forms. An HMO only covers dental care services which are authorized in advance by an individual’s primary care dentist.
- PPO (Proferred Provider Organizations)
These plans are regulated by state insurance departments. PPOs falls somewhere between an indemnity plan and a dental HMO. This plan allows a particular group of patients to receive dental care from a defined panel of dentists. The participating dentist agrees to charge less than usual fees to this specific patient base, providing savings for the plan purchaser. If the patient chooses to see a dentist who is not designated as a “preferred provider,” that patient may be required to pay a greater share of the fee-for-service. A group of dentists agrees to provide services at a deeply discounted rate, giving you substantial savings — as long as you stay in their network. You can go out of network and still receive some benefits. Some typical features of these plans:
- Monthly premiums
- Annual dollar cap
- You must stay within the approved network of dentists or pay higher deductibles and co-payments
- Companies selling these plans are regulated by state insurance departments.
- Scheduled of benefits
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