Dental Coverage
Similar to other health insurance policies, you will pay a monthly premium for your dental insurance while the insurance provider pays for a good sum (if not all) of the price of the services. As usual, the higher premium you pay, the more your insurance will cover when you use these services.
There are some health insurance plans that include dental services in their scope of offerings, but most of the time dental options are purchased separately. Make sure to check before you choose a provider.
What should your dental health insurance cover? The cost of all basic procedures like twice yearly check-ups and cleanings and at least one round of x-rays should be included. Most will cover a portion of other procedures as long as they are medical expenses and not vanity. Teeth whitening, for example, most likely will not be covered. Braces will be covered as long as there is medical need. The more exotic and expensive the procedure, even if medically needed, the smaller the percentage covered by your insurance provider, if they cover any part of it at all.
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Types of Dental Plans Available
You have a wide variety of dental plans to choose from. Check out the following types available before choosing.
Indemnity Plans include:
- Fee-for-services
- Monthly premium paid by the patient and/or the employer
- Insurance company pays 50% - 80% of fees for covered services; the rest is paid by the patient
- Usually a pre-determined deductible paid by the patient, which varies from plan to plan
- Limit the amount of services covered every year
Dental Health Maintenance Organization (DHMO) is an example of a ‘capitation plan’. This type of plan offers
- Comprehensive dental care through designated provider dentists
- Dentist is paid on per person rather than per treatment provided
- Patient pays premiums and co-pays
Preferred Provider Organization (PPO) gives a group of patients dental care from a certain selection of dentists. The participating dentist agrees to charge discounted fees. If the patient chooses to see a dentist who is not a "preferred provider," a larger fee will be expected.
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