Dental Insurance Coverage.

Having dental coverage can help with the unexpected expenses of dental treatments or with cost involved for basic checkups and prevention. Deciding on the right dental coverage can be made simple by understanding the types of dental coverage available and comparing rates and benefits online. The following is a brief outline of common types of dental coverage available through private and employer based insurance policies.

Dental Indemnity Insurance “Usual, Customary and Reasonable” (UCR)
Indemnity insurance is considered traditional insurance coverage that allows you to visit the dentist of your choice. You agree to pay a set amount (premium) and the insuring company agrees to provide reimbursement coverage usually limited by a percentage of the total cost and capped for a maximum payout regardless of final cost.

Dental Health Maintenance Organization (DHMO)
Much like a traditional health maintenance organization DHMO is an enrolment based managed care program. Traditional these types of insurance policies are employer based where participating companies have a minimum of 25 group members. The DHMO plan contracts with select dentist and members must select a primary dentist from list of available choices. Once selected, you are not generally allowed to change until the next enrollment period and the dentist you choose is the only one that your plan will cover. Participating usually services large volumes of people and is often booked out several weeks and not well-known for personalized attention.

Dental PPO (Preferred Provider Organization or Participating Provider Organization)
Similar to DHMO, dental PPO are managed care plans. Rather than having a managed care plan create a network you have a network of dentist that have selected to participate in a savings plan offered to insurers. The added benefit being the dental PPO network will offer insured members of the group a substantial discount and the insurer will be billed at a reduced rate. This can provide and substantial saving to the insurer which equates to lower premiums and allows more freedom of choice to individual members.

Flexible Spending Accounts (FSA)
An employer based plan that account allows an employee to set aside a portion of wages that can pay that can be spent on qualified medical and dental expenses. The money deducted from the employee is not subject to payroll taxes. FAS accounts are subject to the “use it or lose it rule” whereby any money that is left unspent at the end of the coverage period “plan year” is forfeited back to the company.

Direct Reimbursement
Direct reimbursements are self-funded plans, whereby an employer pays for dental care with its own funds, rather than paying premiums to an insurance provider. The patient pays the dentist directly and the employer reimburses the employee a predetermined percentage of the dental treatment expenses.