A Brief Discussion on Dental Insurance Plans

Definition of Dental Insurance Plans

A dental insurance policy is a written contract of insurance designed to cover a wide array of dental treatment and services. All minor and major dental services are shouldered by dental insurance companies with exception of cosmetic dentistry. Dental insurance plans are often provided as an employee perk. Thus, most services included in the policy are decided by the employer.

Coverage of Dental Insurance Plans

The following are the basic dental services covered by a dental insurance plan.

  • Cleanings
  • Bridges
  • Crows
  • Tooth replacement
  • Tooth fillings
  • X-rays such as panoramic x-ray
  • Surgical tooth extraction

More often than not, not all dental services can be covered by the insurance plan. For example, cosmetic dentistry which includes teeth whitening and porcelain veneers.

Most dental insurance plans are indemnity insurance policies in which the overall coverage for dental treatment and services is set in a limited sum. If the patient exceeds the maximum value, he will pay the procedure from his own pocket.

Benefits of Dental Insurance Plans

dental insuranceLike any other types of dental insurance policies, a dental insurance plan protects an individual from unexpected dental costs such as in the case of dental treatment as a result of accident or trauma. If a person has viable dental insurance, he does not need to pay for the treatment from his own pocket.

One caveat is that dental insurance plans will not pay for customary fees. This includes laboratory processes of porcelain and denture. In a nutshell, they do not cover everything. Patients should determine the maximum limit of their insurance policy. An insurance limit of $1,500 would mean that the total costs for all dental procedures performed within the given year should not exceed $1, 500.

The Main Categories of Dental Insurance Policy

An insurance policy holder can benefit from any of the following services.

  • Diagnostic. This refers to the average dental check-ups which may include consultation, normal cleanings, panoramic X-ray and other examination.
  • Basic. This refers to the primary procedures normally provided by dental care facilities. Basic procedures include root canal treatment, gum treatment, permanent fillings and extraction.
  • Major. This consists of dental treatment and services that entail long work and more costs. Examples of major dental services are tooth replacement procedures and creation of crowns.

Insurance companies are the ones that offer products to clients and employers. Employers rely their buying decisions on many factors.

Types of Dental Insurance Policy

There are three types of dental insurance plan:

  1. Indemnity insurance. This is the most common, yet the most expensive type of dental insurance coverage. Indemnity insurance has maximum coverage for all the dental treatment and services. They come in deductibles in which member is obliged to pay monthly premiums.
  2. Preferred Provider Organizations (PPOs). A type of dental insurance policy in which dentists performing the procedure are pre-determined by the insurance company. PPO is less expensive than indemnity plans. In PPOs, patients are not restricted to see other doctors only that patients receive lesser coverage for dental treatment and services. Hence, patients are more likely to pay the treatment at his own expense.
  3. Dental Maintenance Organizations (DMOs). This is the cheapest form of dental insurance. In DMO, dentists receive a share from every premiums paid by patients. Many do not like this type of dental insurance policy because under-treatment of dental problem is very likely.

Note: Dental insurance policies are different from dental plans. The latter only charges a very small amount of premium monthly and is able to get access of minor dental treatments at discounted price.