Dental Insurance Companies

A number of dental insurance companies provide coverage to individuals and employees; each offers a unique set of benefits and covered services for its members. For those who obtain their dental insurance through their employer, plan types may be limited. Individuals can choose from a full range of dental plan choices, but generally pay a higher premium for their coverage unless they qualify for group rate pricing. The basic dental insurance types include indemnity plans, dental HMOs and PPOs, and direct reimbursement plans.

Some dental insurance companies offer indemnity plans; these typically cover visits to any dentist, paying a portion of customary and usual charges for any procedures performed. These flexible plans typically have higher deductibles than other types of coverage and pay benefits up to a pre-set annual maximum benefit limit. Additionally, pre-existing conditions may be excluded from coverage for a certain period of time. Dental HMOs and PPOs offer services through a preferred network of dental providers; patients can usually realize significant savings by selecting an in-network dentist for their care. Some HMOs allow out-of-network services at a sharply reduced rate of coverage; others require that members remain in-network in order to receive any benefits. For HMOs, copayments are usually required for complex procedures, while cleanings and X-rays are offered at little or no cost to the member. PPOs offer a wider range of choice in dental providers, but at an increased cost in premiums and a lower level of benefits for out-of-network providers. Both HMO and PPO coverage is subject to a yearly maximum benefit, after which all service costs become the responsibility of the patient.

For those who wish to avoid traditional dental insurance companies, direct reimbursement plans are a newer offering from some employers. These plans require up-front payment by the employee at the time dental services are rendered. The employee then provides the receipt for dental care to the employer, who reimburses the cost according to the plan’s stated benefits. These plans typically have an annual maximum benefit and may require that employees pay a portion of the expense for dental care; since each plan is set up by an individual employer, direct reimbursement plans vary widely from company to company.