Weighing the options in dental insurance

Weighing the options in dental insurance

Thomas Rodriguez

Dental insurance is an area in which a lot of questions prevail for the normal Medicare policy does not cover the costs of routine dentistry services such as tooth extractions, root canals, fillings, and cleanings. However, given that specialization dentistry is now the order of the day and given that the cost of even routine dental work is expensive, it might be a sound decision to consider going in for a dental insurance plan. Normally Medigap dental plans step in and fill those areas that are not covered under the traditional Medicare policy subject of course to pre-stated conditions of the claim.

Let us weight the different types of plans available and their financial implications.

PPO Plan – the PPO Plan, which is known as the Preferred Provider Organization Plan gives you the option of visiting any dentist of your choice. However, the maximum coverage and least out of pocket expenses are offered to patients visiting dentists who are part of the PPO network. Regarding coverage, a part of your dental procedure would be covered as per the policy, but you would nevertheless have to make a copayment. In such a plan, deductibles and a maximum limit are part of the policy.

An HMO Plan is a prepaid dental insurance plan that allows you to consult only with specific dentists who are on the network. If you require a dental procedure to be done by a doctor who is not in the network or at a facility that is not covered under the plan, then you would have to bear the expenses out of your pocket. While there are no deductibles or maximum limit, this is a coinsurance plan.

Discount plans do not limit you to any network of doctors or hospitals however you would have to meet the plan deductible to be eligible for coverage.

The third kind of dental insurance is known as the indemnity plan, which gives you partial coverage for specified procedures. Under this plan, you have the option of visiting any dentist or dental specialist of your choice, but you would have to cover the cost of their consultancy out of your pocket, as the insurance company does not reimburse the dentists under this plan.

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