A Dental Indemnity Insurance plan is one that is perceived to be a traditional dental coverage plan. This is where you have to pay a certain fee where you are guaranteed to be provided with an insurance that provides good dental service at a reasonable cost.
Under this plan, you are not required to limit your choice of dentist from the network’s list of dental service providers in order to qualify your dental care cost for dental insurance coverage. What you need to do is to pay a certain amount called “deductible” for the indemnity dental insurance. After your deductible is settled, the insurance provider will agree to cover part of your dental costs and your dental insurance will reimburse you for your dental insurance expenses.
However, your reimbursement from the indemnity insurance will depend on the insurance provider. It is possible for some insurance provider to cover at least 80% of your dental expenses or even 100 % as long as they include only the usual and customary dental costs.
The basic reimbursement features of individual dental indemnity insurance are as follows:
- Insurance providers pay up to 100% of preventive dental care. Services included under this item are regular dental examination and teeth cleaning.
- Insurance providers will pay 50% up to 80% the cost of your customary dental services like, tooth fillings, root canals and other dental works as long as it is considered as usual and customary.
However, the main concept of this dental indemnity insurance revolves around the description “usual and customary”. As a rule, the dental insurance will reimburse the insured member for dental treatments that are considered as “usual and customary” by the insurance company. In view of this, your insurance provider will stipulate in your policy as to what are considered to be as “usual and customary”. On your part, it would be best if you read these stipulations very well, so you will know the dental treatment expenses the indemnity insurance plan will cover.
Most often, there is a maximum limit of the dental treatment to qualify as insurance benefit. If you think your dental care needs require more than the maximum limit stipulated, it would be best if you opted for a policy that sets a high limit. This way, you will not have to find yourself shelling out for additional dental costs that will not be reimbursed by your indemnity insurance.
You must bear in mind that everything will be cut and dried according to what is usual and customary and it includes the treatment costs. For this purpose, your dental insurance provider uses the URC Schedule, which is a standardized list of usual and customary dental services to determine the amount of reimbursements due you. URC, stands for Usual, Reasonable and Customary.
Simply illustrated, if your choice of dentist will charge you dental fees beyond the fees indicated in the URC Schedule, then the difference between what your dentists charges you and the fees indicated in the URC will be for your expense.