Dental Insurance Plans-Your Questions on Dental Insurance Plans Answered


dental insurance plansDental insurance plans are highly helpful types of insurance products. They offer consumers the chance to lower the costs of dental care, so they can take better care of their teeth. But these insurance plans for dental care come in many different types, so they can get quite confusing for the first-timer in search for his first dental insurance. The plans may differ based on payments (premiums or annual membership fees), coverage, requirements (deductibles and annual maximums), choice of dentist, and so on.

Before anything else, the main thing you should know is that all types of dental insurance plans cut a big amount from your dental care costs. Some plans cover up to a certain percentage of your dental procedures, while some give you a certain amount you can use up for any procedure you may need. One thing they all have in common is that they translate to bigger savings for you.

What are the Different Dental Insurance Plans?

  • What are PPO plans?
  • What are HMO plans?
  • What are fee-for-service plans?
  • What are discount dental plans?

1. What are PPO plans?

A Preferred Provider Organization or PPO is a type of dental plan offered by dental insurance companies. This type of plan is called PPO because it is made up of members receiving dental care benefits from a single source as they receive dental care from their preferred providers. This is a managed care plan and is now the most common type of dental insurance plans mainly because of the flexibility it offers.

One of the underlying reasons why people go for PPO plans is that they are allowed to choose their own dentists. PPO plan providers have partnerships with various dentists, and some PPO networks happen to be the biggest around. But whether you go to a network dentist or to a dentist that does not belong to the network, you get discounts. The savings you get are larger when you go to a network dentist, but consider the additional amount you have to pay for a non-network dentist a deposit for added trust and assurance that you are with a dental care provider that you trust.

2. What are HMO plans?

The main nemesis of PPO plans is the HMO plans or the Health Maintenance Organization. As implied, the focus of these plans is health maintenance – simple, straightforward, no preferences but just actual, assured maintenance of dental health. In this type of plan, members are allowed to choose a primary care provider; this will be the primary dentist who will take care of all his dental care needs. If there is a need for a specialist, the primary dentist will give the referrals. These primary dentists can be chosen from within the HMO dentist network only. This means your choice of dentist becomes limited.

The focus of such a plan is to ensure that you get regular dental care, not to ensure that you get it from the most highly paid dentist or highly credentialed dentist around. The goal is to make sure dental services are available to you, regardless of the source. HMO networks, however, do make sure the dentists in their group are to be trusted and are highly skilled. Expectedly, this plan option is more affordable.

3. What are fee-for-service plans?

Fee-for-service plans are known by another more commonly used name: dental indemnity plans. Dental indemnity plans are not typical dental insurance plans. Instead, these are membership programs. You do not pay premiums; instead you pay monthly or yearly membership fees. Once you become a member, you get the full benefits the plan offers.

Most fee-for-service plans offer full reimbursement of your dental costs except for select procedures, which are covered based on special specifications. These specifications are usually presented in a fee schedule, which lists down the amount up to which you can reimburse.

These plans also allow members to choose their own dentists with no differences in the benefits they get regardless of which member they choose.

Understanding Dental Insurance Plans: Premiums and Membership Fees

All dental insurance plans require a payment of some sort. Managed care plans such as PPO and HMO plans usually require “premiums,” pretty much like what you pay for your other insurance products. Premiums come with deductibles or co-payments, an amount you have to pay out of your own pocket.

Dental indemnity plans, on the other hand, charge membership fees, either on a monthly or a yearly basis. They do not require deductibles anymore. These plans are often less of a hassle because of less paperwork, and are simpler to understand.