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Types of dental insurance: How are they different, and which one is best for you?

dental insurance
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While we've complied a guide to the best dental insurance providers, most dental insurance companies will offer a variety of plans in your area. You can find plans ranging from affordable discount plans to what might be considered "gold-level" plans. In all, there are four basic types of plans you may choose from. 

Types of dental insurance plans

1. PPOs: Preferred Provider Organizations 

About 82% of today's dental plans are PPO plans. In essence, if you opt for this type of plan, you can choose from a network of dentists who provide predetermined services for a reduced fee. These services are dictated by the provider of the insurance. If you select an out-of-network dentist, unfortunately, you may have to pay full price for a procedure. 

2. HMOs: Dental Health Maintenance Organizations/Capitation Plans

This is the second-most popular type of plan, but its popularity pales in comparison to PPO plans, coming in at about 8% of all policies. This is generally considered to be a more affordable plan for patients because there is no deductible, a low monthly premium, and only a predetermined fee for non-preventative dental procedures. Preventative procedures are usually 100% covered. There tends to be no waiting periods, so you can usually get oral health care right away with an HMO plan.

As it is for PPO plans, a patient must choose an in-network dentist, but HMO plan networks tend to be smaller. 

3. Indemnity plans

Indemnity plans comprise about 6% of all plans. They are less popular than the above policies because they tend to be more expensive, but patients don't need to find an "in-network" dentist. It may also be referred to as a "fee-for-service" or a 'traditional" dental plan. There is an annual deductible, so you'll end up paying for services out-of-pocket until the deductible is met, and then the costs will be split between you and your plan provider. 

4. Discount Dental Plans (DDP)

Discount Dental Plans make up about 4% of all plans. They are not considered to be "traditional" insurance plans, but are rather membership programs that help patients save on dental care costs with dentists that agree to participate in the plans. They are considered to be quite cost-effective, as patients may only pay up to 50% of the dentist's original fees. Discount plans usually only cost about $10 per month per person, and benefits can be used immediately.

Other types of dental insurance plans

There may be other types of dental insurance plans available that are more suited to your needs, but these tend to be much less popular. Those include:

1. Direct Reimbursement

Direct reimbursement plans require that a patient pay for the full cost of any dental procedure, and then submit a paid receipt of proof of services to the provider. Then, the provider will partially reimburse the patient for the procedure performed. Patients can pick any dentist they want with these plans. 

2. Point of service plans

These are plans that offer patients the option to seek out an out-of-network dentist. The patient is then reimbursed a certain percentage of the cost of treatment - but this amount is much less than what the patient would have been reimbursed had he or she sought treatment from an in-network provider. 

3. Exclusive Provider Organizations (EPO)

With this plan, patients must absolutely use an in-network healthcare provider if they want to be reimbursed by the insurance provider. 

4. Table or Schedule of Allowances plans

Table or schedule of allowance plans are indemnity plans. The patient is responsible for the difference between the plan's coverage of the procedure performed and the doctor's fee. The plan's contribution does not change regardless of the amount of the doctor's fee. 

Government plans

The government also offers some dental plans, although those are mostly aimed at children, teenagers and military personnel. Those plans include:

Medicaid and CHIP

Children under the age of 21 who are insured by Medicaid and CHIP have covered dental costs. However, coverage may vary for adults who have Medicaid or CHIP. 

Tricare

This is the program that benefits active military service members and their families.