Know What Type of Dental Plan is Right for You

Discount Dental 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 bigger. Then of course, using a specialist means smaller discounts. Ultimately, discount dental plans are the cheapest type of dental plan available. Plus, there’s no pre-existing conditions or waiting periods so you can begin using it right away.

HMO Dental Plan

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

PPO Dental Plan

There are several PPO type plans available – each with their 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. PPO plans also cover major services like root canals, crowns, dentures, etc. For both basic and major services, there’s typically a 12-month waiting period. Additionally, there’s usually a deductible. A routine and 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 the deductible is met, 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 the deductible is met. For the most part, the cost of major services is a 50/50 split.

Unlike a discount plan or HMO plan, PPO plans has 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, then 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. Meaning, they still have the 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, either you or the company can file the claims; so with the exception of 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. And as for price, indemnity plans cost roughly the same as a PPO. Ultimately, there’s not a huge difference between this plan and a discount plan. So if seeing a particular dentist or specialist is a priority, then 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!

Since insurance is oftentimes overwhelmingly confusing, we want to shed light on this industry by answering YOUR questions.  So if you have any questions or concerns, comment below and your question may be the topic of our next video!

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