Dental Insurance – The Basics

Dental Insurance

Dental Coverage

When it comes to understanding dental coverage, there are some things that you need to be familiar with. In this article, we cover the basics of insurance plans, some important terms, and different types of dental plans.

Basics

  • Inspired Dental a Papillion Dentist accepts different types of dental insurance plans and each of them comes with different features and benefits. This means, you should do your research, so you know exactly what you are getting. For instance, while two plans might be offering complete coverage, they might be different in terms of copayment.
  • Keep in mind that in certain situations, having multiple dental plans or dual coverage might be more feasible. Just make sure that both plans don’t exceed your dental expenses when availing yourself of this opportunity.
  • We also caution against knowing when your benefit period ends because it might not necessarily mean a calendar year.

Important Terms

Deductible
Amount to pay before your benefit plan can begin.

Maximums
The highest amount a dental plan will pay within the benefit period.

Coinsurance
For people who have a fee-for-service benefit plan, you pay the balance after the plan pays a percentage of your treatment cost.

Reimbursement Levels
The different coverage categories offered by fee-for-service dental plans will be reimbursed to varying extents. Dentists suggests that diagnostic and preventive procedures, such as cleaning, offer the highest reimbursement amounts. On the other hand, major procedures, such as crowns, will be reimbursed at lower percentages.

Dental Plans

Preferred Provider Organization (PPO) Plans
Often, these plans balance out costs (lower) with dentist choice (high). Since the PPO dentists are a part of the network, you pay the coinsurance. Again, the type of procedure that you are getting done will matter. You will pay less for preventive services since most of it will be paid for by the plan.

Dental Health Maintenance Organization (DHMO) or Prepaid Plans
When choosing these plans, you are limited to one dentist or dental facility. People, who opt for this plan, pay a fixed amount or copayment. There are no deductibles or maximums with this plan.

Fee-for-Service Plans
Like the PPO plans, you pay the coinsurance amount for these plans as well. However, the amount reimbursed to you will be smaller than it would have been for a PPO plan.

Discount Plans
Also known as reduced-fee-for-service plans, these aren’t actually insurance plans. Through them you can access certain dental services at discounted rates. Since this isn’t insurance, there is usually no paperwork to fill. The same is true for any limits or deductibles. Not all dentists treat patients as part of discount plans, so you will have to confirm if you are going to a participating dentist.

We would advise that you read up as much as you can on what your plan offers. It is also important that you familiarize yourself with the terms commonly associated with dental insurance. Coming across this knowledge when you need to fall back on your plan is bound to result in a rude awakening!