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Plan Comparisons and Coverage Guide for Dental Insurance

Dental insurance offsets the cost of dental care. It helps because dental treatments range from $300 per year for regular dental hygiene to over $25,000 for restorative dental procedures or cosmetic dentistry.

Dental insurance plans often have limitations on the number of dental visits, X-rays, and covered treatments. Some plans only reimburse you if you choose the least expensive treatment alternative, while other plans will not cover pre-existing conditions.

Before you buy a dental plan, check with your employer whether they offer dental insurance and see if a flexible spending account option is included.

Let’s take a look at the different types of dental insurance plans.

Indemnity plan: This plan lets you choose your own dentist and is considered a fee-for-service plan. They come with limitations and co-payment options. You pay a flat fee for dental visits, but an annual limit is set on the coverage for dental spending. Specific coverage limits are also set for individual dental procedures.

Self-insurance plan: These are similar to indemnity plans, but you may not be allowed to choose your own dentist.

Closed panel plan: Here, you are limited to using a specific group of facilities along with the number of dentists that you can consult.

Capitation plan: These plans appoint specific dentists for intervals of treatment. The dentists have a contract that pays them a fee whether or not dental treatment was required.

Preferred Provider Organization(PPO): PPO dental plans are limited to include a group of dentists that are assigned to provide dental care at reduced costs.

Direct reimbursement plan: These plans allow employers to reimburse employees for any dental services that they receive directly.

Dental care service plan: These plans use a group of dentists who form a non-profit organization to provide dental services at set fees.

What’s covered: Go through the plan carefully to understand what is covered and how it is covered. Say you need a dental filling and want a composite filling. Check the benefits in your plan for composite fillings because many insurance companies only reimburse those at a rate equal to amalgam filling and require you to pay the rest. Cosmetic dental procedures are often not covered at all except for some restorative purposes.