Dental Insurance Quick Guide

What is Dental insurance?

Dental insurance is a type of coverage that is designed to pay for a portion of the costs associated with dental care. Similar to medical insurance, there are several types of individual, family, or group plans that are made available for purchase through a multitude of insurers. Dental insurance may be acquired through work (by an employer), a local licensed insurance agent or broker, or by purchasing a policy online, through a web site that is licensed to sell dental insurance products.

In a general sense, a dental insurance plan will cover a percentage of the costs associated with dental charges and similar to medical insurance policies, dental care will incorporate a wide variety of coverage options which may include free preventive services such as routine cleanings. Dissimilar to the field of medical insurance, dental coverage does not possess an industry standard in regards to the annual maximum limitation, co-pay, or deductible present in a given plan. The intricacies that make up coverage and the specific benefit limitations that are found in a particular coverage are determined by each individual insurance company as filed with the department of insurance.

Types of Dental Insurance Coverage:

DHMO: Refers to a Dental Health Maintenance Organization. This form of coverage is a common capitation plan where the individual and coordinating family dentist is paid based on a per capita or per person basis as oppose to payments for the actual treatment provided.

Indemnity: This type of plan refers to individual policies; the holder will choose an individual or family dentist. An indemnity insurance plan will pay the dental office on a traditional fee-for-service basis where a monthly premium is required by the client and or the employer who offers the plan to the underlying insurance company. The insurance company will then reimburse the clients for the services rendered.

Preferred Provider Organizations: This is another form of a true dental insurance plan. A Preferred Provider Organization plan falls between an indemnity plan and a dental HMO because it allows a particular group of patients to receive care from defined panel individual dentists.