Dental Plan Type

We currently offer 4 types of dental insurance plans. They are:

Indemnity

An indemnity plan is commonly known as a fee for service or traditional plan. If you select an Indemnity plan you have the freedom to visit any dentist. You do not need referrals or authorizations; however, some plans may require you to precertify for certain procedures. Most indemnity plans require you to pay a deductible. After you have paid your deductible, indemnity policies typically pay a percentage of "usual and customary" charges for covered services; often the insurance company pays 80% and you pay 20%.

PPO

A Dental PPO (Preferred Provider Organization or Participating Provider Organization) provides dental care to its members through a network of dentists who offer discounted fees to its plan members. You can typically use dentists out of the PPO's network, but you will only be reimbursed the discounted fee for the services rendered - you will need to pay any additional amount yourself.

HMO

HMO dental insurance plans typically require that members obtain services only from a select group of dental providers in order to be covered. Dental HMO plans may sometimes offer less expensive monthly premiums, but may also allow you less freedom to choose your own dentist.

Network

A network of dentists who have agreed to provide dental services to an insurance plan's members at discounted costs. While the insurance plan's members are free to use any dental care provider, the cost to use network providers is often less than using non-network providers.

Participating

This plan provides options for anyone looking for affordable dental coverage that works like a typical insurance plan (e.g. deductibles and coinsurance). Three plan options range between a plan covering only diagnostic and preventive services to a more comprehensive plan.

With all plans, you can choose any dentist but you may pay more for a service if you visit a non-participating dentist. Participating dentists have agreed to payment rates for covered services and cannot charge more. When you see a non-participating dentist, you may be billed the difference between what the plan pays and the non-participating dentist charges for the procedure.

 

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