Dental Insurance Information
When it comes to dental plans there are several ways they can be set up. Obviously, this is a type of coverage that can be offered through an employer. However, you can also purchase this as an individual plan for yourself and your family members. One of the biggest things you have to watch for is the benefits that are covered in the plan. Some plans do not cover any major dental work. You also need to be aware that many plans will have a waiting period before certain benefits will pay. This is to protect the insurance company since these plans are typically guaranteed to issue.
When it comes to dental plans, here is some information that will help to know the differences of the plans and how they can operate.
1. Indemnity Plans
- These plans pay a specific amount for each type of dental service that you receive regardless of the actual cost. For example, it may pay you $120 for a cleaning, $50 for an extraction, $250 for a root canal, etc. These type of plans can pay you directly, and you just pay the bill to the dentist. These plans can be beneficial if you like to negotiate with the dentist, or try to find a dentist that gives the best rates. These type of plans can sometimes provide as much out of pocket savings compared to a traditional plan. It just puts more responsibility on the insured.
2. Traditional Plans
- These plans are the most common in many of your employer groups. It is a fee for service type of plan that pays the dentists fees up to the plans maximum. A common type of plan will pay 100% for cleanings, 80% for basics, and 50% for major work, though there are plans that are variations of this. These type of plans typically pays directly to the dentist.
3. PPO Plans
- These type of plans have a specific network of dentists that contract with the carrier to accept a specific amount for each procedure. They provide a better discount for the services. If you go to a dentist that is not contracted to the plan, you may have a larger fee, and the plan usually pays a smaller percentage. For example, the plan may pay 100% for cleanings if you use a network dentist, but only pay 80% if you go to an out of network dentist. The advantage of PPO pans is they may have negotiated a deeper discount allowing you to get more procedure covered before your maximum is met.
4. No Network Plans
- These plans allow you to go to any dentist. There are no networks of dentists. Many of these plans pay on a 90% scale. In other words, they pay what 9 out of 10 dentists charge. If you happen to go to the most expensive dentist, you would have an extra amount to pay for the difference. The percentages paid on these type of plans are basically the same as a PPO plan, accept there is no out of network dentists. The advantage to these type of plans is you never have to look for network dentists. This could be a great benefit if you are in rural areas where there are not many dentists available.
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