Choosing a dental insurance plan that suits your pocket and fulfils your dental requirements is not easy. You need to know the different types of dental plans available, their coverage limits, and how much you need to pay out-of-pocket in each plan. In order to reap maximum benefits, you need to know the available dental insurance plans in detail. If dentists and patients both are equally aware of the plans, it will keep them on the same page during treatment in terms of coverage and payment. This article will explain the different types of dental insurance plans and how each plan functions.
Types of Dental Insurance Plans
Here are some of the most common types of dental insurance plans:
1. Dental PPO Plan
Dental Preferred Provider Organization plan or DPPO plan is one of the most common types of dental insurance plans. The plan covers a wide network of dentists making it one of the most popular plans as well. It even allows patients to visit out-of-network dentists and still receive partial coverage for it. A DPPO plan usually comes with an annual deductible. Your plan starts sharing costs once you meet your deductible.
|You are not required to choose a primary care dentist.
|You may need to pay an annual deductible for routine dental services.
|Cost-effective if you see in-network dentists
|Pays less for the services received from out-of-network dentists
|Most in-network preventive dental care services (cleanings, routine procedures, and X-rays) are completely covered.No COPAY options, So the insurance will cover for most of it.
|Comes with an annual maximum that may restrict the amount of coverage in a year
2. Dental HMO plan
A Dental Health Maintenance Organization plan or popularly known as DHMO plan is another widely known dental insurance plan. It’s quite similar to an HMO health insurance plan. It allows you to visit in-network dentists keeping your costs at a minimum. It usually does not cover out-of-network dentists except for some emergency services.
The plan requires you to choose a primary care dentist from the network that is typically your first point of contact. The in-network dentists offer certain services at reduced or no cost to the plan members.
|It usually does not have a deductible.
|Offers a small network of dentists in comparison to the DPPO plan
|Usually comes with no annual maximum for covered services
|Difficult to find local in-network dentists
|Preventive dental care is covered completely.
|Need referral if you wish to see a specialist
3. Dental Indemnity plan
If you wish to visit any dentist of your choice and are not worried about the costs, the Dental Indemnity plan is for you! Renowned as a traditional dental plan or Fee-for-service plan, it allows you to see any dentist as there is no pre-defined network of dentists to choose from.
In a dental indemnity plan, an insurance company pays a percentage of the charges based on the procedures performed. The plan does not force you to choose a primary care dentist and you may not need referrals to see specialists or receive emergency dental care.
|Freedom to visit a dentist of your choice
|Comes with an annual deductible and coinsurance
|Need no referrals to see specialists
|Higher out-of-pocket costs if you visit out-of-network dentists
As a dental indemnity plan usually has an annual deductible and coinsurance, you need to pay out-of-pocket costs until you meet the deductible. Your plan will share costs for covered services, up to what is considered usual, customary, and reasonable (UCR).
4. Dental EPO plan
A Dental Exclusive Provider Organization (DEPO) plan allows you to visit only in-network dentists. Although it doesn’t require you to choose a primary care dentist and you don’t need referrals to see specialists, it restricts you from visiting out-of-network dentists. A DEPO plan usually has a deductible and a coinsurance.
5. Dental POS plan
Dental Point of Service (DPOS) plans have features of both DPPO and DHMO plans. It covers both in-network and out-of-network dentists but costs stay lower if you visit dentists within the network. You are required to choose a primary care dentist who helps you with referrals if you need to see a specialist.
There are some other types of dental insurance plans available such as Direct Reimbursement plans, Discount or Referral plans (technically not insurance plans), and Table or Schedule of Allowances Plans.