Know What Type of Dental Plan is Right for You

Discount Dental Insurance Plan

If you’re looking to purchase a dental plan on the individual market, then you should know about the four main types of dental plans. First, there’s the discount dental plan. With this type of plan, there is a network of providers. Technically, it’s not real insurance. It works by offering discounts for particular services, depending on whether you’re visiting a specialist or general dentist. With a general dental practice, the discounts are usually better. Then, of course, using a specialist means smaller discounts. Ultimately, discount dental plans are the cheapest type of dental plan available. Plus, there are no pre-existing conditions or waiting periods, so you can begin using it right away.

HMO Dental Insurance Plan

As for HMO dental plans, there’s a scheduled benefit structure. In other words, using the plan’s small network of providers allows you to receive services at a low cost. This plan type comes with the standard cleanings twice a year. Aside from the cleanings, other dental services have a discount rate of anywhere from 30-60%. There’s neither a cap nor a waiting period so you can use it immediately. The HMO dental plans have smaller networks than discount plans and are a little more expensive.

PPO Dental Insurance Plan

Several PPO-type plans exist – each with its own network of providers – that vary in how they cover preventative and basic services. The preventative services cover routine exams and cleanings, while basic services include fillings and simple extractions. Also, PPO plans cover major services like root canals, crowns, dentures, etc. There’s typically a 12-month waiting period for both basic and major services. Additionally, there’s usually a deductible. A routine exam usually waves the deductible and is covered 100%. As for basic services, which again have waiting periods, the insurance company typically pays 80% once you meet the deductible, leaving you to pay the other 20% of the bill. Then, there are major services, which can have up to a year-long waiting period. Under a PPO plan, insurers cover 50% of major services once you meet the deductible. Mostly, the cost of major services is a 50/50 split.

Unlike a discount plan or HMO plan, PPO plans have a cap for the amount they’ll spend each year. The cap could be anywhere from $750 to $2,500. So, for example, if you underwent a major procedure like a root canal and the bill was $1500, then the insurer would split the cost and pay $750. If your plan’s maximum is $750, you must wait until the following year to use the plan again.

Indemnity Dental Plan

Indemnity dental plans are very similar to a PPO plan. They still have waiting periods and cover the three primary categories of services. However, unlike a PPO plan, you can see any provider you want with an indemnity plan. Depending on the insurer, you or the company can file the claims, so except for the networks, indemnity plans function much the same way as a PPO.

Because this type of plan allows so much freedom of choice in terms of providers, this is the best option. As for price, indemnity plans cost roughly the same as a PPO. Ultimately, there isn’t a significant difference between this plan and a discount plan. So, if seeing a particular dentist or specialist is a priority, this plan is worth the investment. Talk to an agent today to see if this plan or any other type of dental plan is right for you!

Have Health Insurance Questions?

We hope that this information on dental plans was helpful for you.

Insurance is oftentimes overwhelming, and we want to shed light on the industry by answering your questions. Comment below and your question may be the topic of our next post!

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This article was revised on 5/9/24.

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