Dental Insurance FAQs

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¹Dental quotes based on a 35 year old, single female in the 92101 zip code.

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Dental Insurance FAQs

Find Answers To Common Questions About Dental Insurance

How does dental insurance work?

Dental insurance works similar to the way medical insurance works. Members pay a monthly premium, and in return, are entitled to certain dental benefits. Dental benefits can vary from plan to plan. Some will provide broader coverage than others and some will require members to pay co-pays at the time of service. In addition, some plans may also provide coverage for certain types of oral surgery, dental implants, or orthodontia. It is important to always check the details of the plan benefits to ensure you have the coverage you need.

What types of dental plans are available?

Dental insurance plans are categorized similar to health insurance plans, meaning they are likely Indemnity or managed-care (PPO) plans. The major differences are choice of dental care providers, out-of-pocket costs and how you are billed. Typically, Indemnity plans offer a broader selection of dental care providers than managed-care plans. With Indemnity plans, you may have to pay up front and then get reimbursed by your insurance company.

Managed-care dental plans generally maintain networks. Dentists participating in the network agree to perform services at pre-negotiated rate and submit the claim directly to the dental insurance company. Essentially, there is less paperwork and lower out-of-pocket costs with a managed-care dental plan, but a broader choice of dentists with an Indemnity plan.

What is a Dental PPO Plan?

Dental PPO (Preferred Provider Organization) plans are the most popular type of managed care dental insurance plans. Most Dental PPO plans have a deductible. With a Dental PPO plan the member typically obtains services through a network of dental providers who agree to serve the plan’s members at reduced rates. When you use a network provider, you will typically pay a certain percentage of the reduced rate, and the insurance company will pay the remaining percentage.

What is a Dental HMO Plan?

HMO dental insurance plans generally require members to receive services only from a select group of dental providers in order to be covered. Dental HMO plans may sometimes offer less expensive monthly premiums and have little or no waiting periods, however, they may limit your options in the number of dentists you can choose from.

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