When deciding what sort of dental insurance to get, it’s vitally important that you know what procedures you’re receiving coverage for. It is a frustrating experience to show up for a treatment and give your dentist your insurance details, only to find out a few months later that you’re on the hook for medical expenses worth thousands, simply because you didn’t check your coverage beforehand! Let’s explore what’s covered by each type of dental insurance, as well as what you can’t receive coverage for, so you’ve got the full picture before deciding on your dental plan.
A PPO is a type of dental insurance plan which gives you access to an entire network of dentists in your local area at a reduced rate. You can choose to go outside of the network if you want, but your rates will go up. The typical PPO covers:
Most PPO plans have what’s known as 100-80-50 coverage. This means that the plan pays for 100% of your routine preventative and diagnostic care, 80% of your basic procedures such as root canals and fillings, and 50% of your major procedures such as bridges and crowns. But remember, unless the cost of your procedure meets your deductible, your PPO plan won’t cover any of your bills.
A DHMO, Dental HMO, restricts your dental insurance coverage to a relatively small network. DHMOs tend to cover the same procedures as PPOs, the only thing that differs is the rates that you pay for each treatment. In a DHMO, the rates are usually lower, and you’ll rarely have to pay anything for preventative or diagnostic treatments such as x-rays and basic examinations. In addition, DHMOs tend to charge lower co-payments (the amount you pay for each service) than PPOs.
An indemnity plan (also known as a traditional dental plan) allows you to visit any dentist in the world. You’ll have to pay the full cost of your treatment up front, and then submit a claim to your insurance provider. They’ll pay a percentage of the cost, and you pay the rest. Typically, the procedures that you can receive coverage for are the same as PPOs and DHMOs.
Just as important as what is covered by dental insurance is what isn’t covered:
Now that you know what sort of dental insurance coverage you can expect to receive from the various types of dental insurance plans, you can choose a plan that really works for you.
Need help finding a Dentist with the right dental insurance plan for you? Call 1-800-DENTIST today to see how we can help!