Understanding the Subtle Differences Between Supplemental Dental Insurance Providers

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Supplemental dental insurance providers vary in the manner in which they offer benefits. Finding the right provider that fits your budget and covers the services you need is essential.

Supplemental dental insurance providers deliver benefits in many ways. Understanding how various providers offer benefits will ensure that you find a plan that provides cost-effective care that also covers your dental health needs.

Most supplemental dental insurance providers are grouped into two categories: “fee-for-service” or “managed care”.

Two types of fee-for-service plans1:

  • Indemnity Plans: Patients enjoy freedom of choice when selecting their dentist. But, they must pay their bill in full at the time of service. The insurance provider reimburses the patient after reviewing the dentist’s bill. Patients can request a pre-estimate of their dental work to determine their out-of-pocket expense. Patients can also check with their dentist to see if dental financing is available.
  • Direct Reimbursement Plan (DR): Patients can choose any dentist they want. These plans reimburse individuals based on the dollars spent on dental care. The DR model is the American Dental Association’s preferred approach to financing dental care.

Two types of managed-care plans:

  • Dental Maintenance Organization (DMO): You select a primary care dentist within a network. Then, you receive dental care at no cost or at a reduced price. DMOs are usually the least expensive option. They do not typically require a deductible or impose an annual maximum (the most the plan will pay toward services in a year.)
  • Preferred Provider Organization (PPO): The provider arranges lower rates with dentists within a network. You are still covered to see an out-of-network dentist, but you will pay more out-of-pocket. These types of plans frequently cover preventive services at 100%. More advanced treatments are covered at a lower percentage.

HealthMarkets Can Help You Weigh Your Options

If you are unsure which supplemental dental insurance provider to choose, contact HealthMarkets Insurance Agency. Our licensed insurance agents can help you in person or any time over the phone at (800) 360-1402.

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1Plans vary by state

Sources

http://www.ada.org/en/public-programs/dental-benefit-information-for-employers/insurance-and-financing

https://www.dentalinsurance.com/frequently-asked-questions

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