Common Questions About Dental Insurance Plans

Posted on: 30 December 2015

More and more people are realizing the importance of dental insurance cover and the convenience that dental insurance plans provide. As such, a large number of individuals are investing in dental insurance plans for themselves and for their families. Choosing a dental insurance plan is easier said than done. This article provides answers to a few questions that first-time clients often have when looking to invest in a dental insurance plan.

What Is Covered Under A Dental Insurance Plan?

This is perhaps the first question that a prospective client will have when looking for dental insurance. Often times, the answer to this question determines whether or not the client will go ahead and get insured.

Covered dental services differ from one dental insurance plan to the next (and from one company to the other). However, there are certain services that should be covered under a typical dental insurance plan. Top on the list of these services include routine and preventative dental care. This refers to regular check-ups, application of sealants on teeth for cavity protection, fillings, and x-rays among other services.

Standard dental insurance plans should also provide cover for dental emergencies (e.g., when an insured patient cracks, breaks or loses one or more teeth in an accident).

Lastly, the typical plan should provide cover for complex dental care. This includes services related to dental fixtures such as bridges, dentures, and implants.

What Major Advantage Does A PPO Dental Plans Provide Over Their DHMO Counterparts?

Preferred Provider Organization (PPO) insurance and Dental Health Management Organization (DHMO) insurance are among two of the most common types of dental insurance plans available to the public. A large number of first-time shoppers often end up faced with a final decision between the two types of dental insurance.

PPO dental plans are primarily preferred for the fact that they allow patients greater flexibility in terms of the dental practitioners that they can choose for service provision under the plan. With PPO dental insurance, patients are still covered even when they visit dental practitioners not within the insurer's network of preferred practitioners. However, the patient ends up paying more for dental services than what they would have paid working with a network professional.

What Is The Difference Between Co-payment and Co-Insurance?

The two terms above are common (and often confusing) in the context of dental insurance. Co-payments refer to a specific amount that insured patients are required to pay out-of-pocket whenever they receive dental service. The amount is usually a flat-fee.

On the other hand, co-insurance refers to a situation in which the patient is required to pay a percentage of the cost for dental services rendered. The insurance company takes responsibility for the remaining percentage. The percentage of service costs to be paid by both the insurer and the patient on dental visits is agreed upon prior to getting into the insurance agreement.

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