There are many different types of dental coverage, ranging from private to state government plans. As you will know from our guide to the best dental insurance providers, most companies offer a variety of plans, but not all of them are available in every state.
You can find oral care coverage plans ranging from basic yet affordable, right up to what might be considered 'gold-level' plans. In general, there are four main different types of dental insurance to choose from. Let's take a look at these now...
Different types of dental insurance
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, you may have to pay the whole cost of 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. Speaking of prevention, using one of the best electric toothbrushes (opens in new tab) for two minutes twice a day can vastly improve the health of your teeth and gums, so try to make this part of your daily oral hygiene routine.
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 dental coverage 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.
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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 use an in-network healthcare provider if they want to be reimbursed by the insurance provider.
4. Table or Schedule of Allowance 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.
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.
This is the program that benefits active military service members and their families.