Comparing Dental Insurance Plans Author:    Posted under: Health InsuranceHealth Insurance Types

When people think of obtaining health coverage, dental insurance doesn’t usually make the cut. Let’s face it, oral healthcare is just not a priority for most individuals, even for most families. As a matter of fact, not all employers include dental coverage in their health insurance package for employees. But if you ask someone who’s recently had dental work done, you’d be surprised to know just how much it cost them to have that tooth extracted, or how much they had to pay for their kid’s braces. The rising costs of dental services should be enough to convince you to get that dental coverage now.

These days, dental treatments can cost anywhere in between $300 per year for regular dental hygiene check-ups and $25,000 or more for restorative procedures.

If you’re just starting to research on the different types of dental plans there are, it can be confusing given their sheer number – add to that the similarities and differences between each one. There are various dental plans available in the market. It is important to note that dental insurance plans cannot be compared to health insurance coverage, because the dental plans will almost always offer fewer benefits.

Dental insurance companies usually cover the cost of pre-emptive care such as check-ups, cleanings and x-rays but consumers need to be aware that dental plans have restrictions on the number of x-rays, check-ups, and treatments that are covered, while other services may not even be included. However, people usually choose to go years without dental visits to save on out-of-pocket expenses for these so having dental coverage should encourage these policyholders to make use of them. These are extremely necessary to keep teeth and gums healthy and for the early detection of any dental issue.

There are dental plans that cover the cost of certain kinds of dental treatments including but not limited to cavity fillings, crowns and tooth extractions. And your coverage may easily add up to thousands of dollars annually even if your dental insurance only covers a portion of the costs for these treatments and services.  A good rule of thumb would be to take all the dental treatment you have had over the last two years for you to better be able to assess what kind of coverage you need and what plan will best be able to give you that. One more thing worth noting is the fact that more often than not, the cost cosmetic dental procedures will not be offset by insurance.

The following are the types of dental insurance plans that you will choose from:

Indemnity plan This type of dental plan allows you to choose from an “open panel” of dentists. The insurance plan provides payment for dental services and treatments obtained by the covered individual on a fee-for-service basis and may come with limitations and co-payment options. In some cases, the insurance company may pay for a dental procedure in full, while in other cases, the insurance company may only cover between 50 and 80 percent of the total cost. The difference will have to be shouldered by the individual who received the treatment as an out-of-pocket expense.

Managed care dental insurance plans:

  • Capitation Dental Plan (Dental Health Maintenance Organizations) – This type of plan contracts dentists and dental offices to provide dental treatments and services to the plan’s enrolled members. The policies for each capitation insurance plan will vary from company to company, but some types of dental procedures (such as cleanings, x-rays and check-ups) are usually provided at no charge to the member, while other dental procedures (such as dentures, crown and bridgework) may require a co-payment. For this type of plan however, the member will not have much flexibility with regards to a choice of dental health provider. You may be required to choose from within the network of dental professionals for your dental care.
  • Preferred Provider Organizations (PPO) Dental Plan – Similar in nature to the dental HMO, a dental PPO contracts dentists and dental offices from which you may select dental health providers to manage your care in order for you to be provided the maximum benefits, which is usually discounted prices for in exchange for their services. Unlike dental HMO though, members of a dental PPO are given the flexibility of choosing to receive dental treatment from a dentist who is not a member of the network. However, you may expect to pay higher deductibles and co-payments.

Direct reimbursement plan – This type of plan allows employers to directly refund employees for any dental services and treatments received.

Discount or referral dental plan – This dental benefits program is technically not dental insurance at all. A third party, a dental plan company, usually contracts dentists who have agreed to charge discounted fees for their services in exchange for patient referrals from the dental plan company. While the patient has to pay a fee to become a member of the plan, he or she will still directly pay the pre-determined discounted fee for the services rendered by the dentist.

Before you decide on any plan, it is best to examine which one will suit you or your family’s needs. The internet has made it easy for everyone to get online dental insurance plan quotes, in order for the consumers to compare and make informed decisions. Utilize these tools and you will find that although the figures are mere estimates, you will see which plan will be able to give you more dental coverage.


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