Difference between Dental Insurance and Discount Dental Plans

According to the National Association of Dental Plans, forty-six percent of the U.S. population does not have dental insurance. How does dental insurance differ from a discount dental plan? Similar to medical insurance plans, dental insurance plans are often categorized as either Indemnity or managed-care plans. The major differences concern out-of-pocket costs, choice of dental care providers, and how bills are paid.

Typically, Indemnity plans offer a broader selection of dental care providers than managed-care plans. With an indemnity plan, the carrier pays for covered services only after it receives a bill, which means that you may have to pay up front and then obtain reimbursement from your insurance carrier later.

Managed-care plans typically maintain dental provider networks. Dentists participating in a network agree to perform services for patients at pre-negotiated rates and usually will submit the claim to the dental insurance company for you. In general, you'll have less paperwork and lower out-of-pocket costs with a managed-care dental plan and a broader choice of dentists with an Indemnity plan.

What’s Covered by Dental Insurance?

If you have dental insurance, familiarize yourself with your plan so you know which dental procedures are covered. Cosmetic dental procedures are not typically covered by dental insurance. However, if you have insurance and require veneers for restorative purposes, ask your dentist about the possibility of filing for reimbursement for a percentage of the costs. Also, be sure to check if any specialty services such as root canals or orthodontic bite adjustments costs are covered by insurance.

More often the cost of cosmetic dentistry will not be covered by dental insurance. Dental insurance plans differ in the level of reimbursement offered for certain procedures and in the annual allowance spending limitations. Some plans limit the waiting period before certain dental treatments are rendered and have exclusions, meaning that costs for certain dental procedures will not be reimbursed.



What does the discount dental plan offer?