Dental insurance, PPO’s and Indemnity dental insurance plans.
Since I left my job I was on cobra for a while. I just found out that my cobra plan is cancelling this month. I called my dentist to find out what dental plans I need to get in order to stay with their office.
I was told they only accept PPO’s and Indemnity dental insurance plans. Nothing elese. I am not sure what the difference is between a Indemnity dental and a PPO dental plan. Which is the best one to get?
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Tuesday, Jul. 20th 2010 11:01 AM at 11:01 am
PPO Dental Insurance
PPOs falls somewhere between an indemnity plan and a dental HMO. This plan allows a particular group of patients to receive dental care from a defined panel of individual dental insurance dentists. This type could be used to provide dental gap insurance.
The participating individual or family office agrees to charge less than usual fees to this specific patient base, providing savings for the plan purchaser. If the patient chooses to see one who is not designated as a “preferred provider,” that patient may be required to pay a greater share of the fee-for-service.
A group of individual or family dentistry providers agrees to provide services at a deeply discounted rate, giving you substantial savings — as long as you stay in their network. Unlike the more restrictive DHMO, though, you can go out of network and still receive some benefits. Some typical features of these plans:
Monthly premiums
Annual dollar cap
Waiting periods
You must stay within the approved network of individual or family dentists or pay higher deductibles and co-payments
Indemnity Dental Insurance
This is the plan where you choose your own individual or family dentist. The dental insurance plan pays the dental office on a traditional fee-for-service basis. A monthly premium is paid by the client and/or the employer to an insurance company, which then reimburses them for the services rendered.
A dental insurance company usually pays between 50% – 80% of the family or individual dental office fees for a covered procedures; the remaining 20% – 50% is paid by the client. These plans often have a pre-determined or set deductible amount which varies from plan to plan. Indemnity dental plans also can limit the amount of services covered within a given year and pay them based on a variety of fee schedules. Some typical features of these plans:
Deductibles before coverage begins
Probationary periods on certain procedures that last up to a year
Annual dollar limit on benefits
Chose your own individual or family dentist
Companies selling these plans are regulated by state insurance departments.