Individual and Family Dental Insurance Plans
As an independent broker, e-Cover Me offers various types of affordable dental insurance for you and your family. There are several types available, although the best guidance we can give depends on your specific situation.
Indemnity Plan: These programs tend to be the least expensive along with usually having the benefit of no waiting periods, especially for major services such as root canals, dentures, bridges, and implants. Indemnity plans often give you the flexibility to select your own dentist, but the downside to the plan is that you are often responsible for the bulk of the costs. These plans are considered fee-for-service, which means for the services provided, the dental insurance company will have a discounted amount you are responsible for, but the company itself doesn't usually pay the dentist directly. For example, your preventive exam, x-rays, and teeth cleanings may be covered with a small copay of $5-$20 per service. Cavities are often filled for a copay of $40-100 depending on the severity.
This plan may be best for clients that have urgent needs, have had no dental coverage, but are looking for at least a discount on the cost of their immediate care.
Preferred Provider Organization (PPO): This is the more traditional, benefit-rich dental insurance that we most often recommend. It provides heavy discounts for utilizing dentists that are in-network and best limits out of pocket expenses. Most PPO dental insurance will cover preventive care, including exams, x-rays, and teeth cleanings twice per year per person at 100%, no copay. For basic services such as fillings/cavities, non-surgical tooth extractions, and emergency treatment, there is often a small deductible to be paid first and then, the insurance company will cover anywhere from 50%-80% of the remaining, discounted charges. For major services such as implants, root canals, periodontal scaling and deep cleaning, bridges, and dentures, it is subject to the same per-person, small deductible and then the insurance company will pay 20%-50% of the remaining discounted charges. While PPO's do pay the dentists directly and offer the lowest out of pocket costs for clients, there are often 3-12 month waiting periods on basic and major services. If you have had continuous and qualified dental insurance with a gap of less than 60 days, certain carriers will reduce or even waive these restrictions, making PPO's the program of choice for these clients.
Dental Health Maintenance Organizations (Dental HMO): This is a blend of the Indemnity and PPO dental insurance programs. Similar to an HMO in health insurance, you will select your primary dentist or one will be selected for you based on where you live and who is accepting new patients. It tends to pay lower benefits for covered services, but it also tends to have lower waiting periods. Traveling out of state, needing specialized service such as orthodontia, or wanting to stay with your current dentist all become challenges with DHMO's, so it is the least popular option with most clients. That being said, sometimes it will make the most sense to accept the limitations to capture the premium savings.
Choosing a dental insurance plan is not nearly as complex as selecting the right health and life insurance program for you and your family, but it always helps to have a licensed professional that's familiar with your needs to help guide you in the process. As with all insurance products, there is never an additional charge to work directly with the brokers at e-Cover Me, so if you are in the market for dental insurance, please feel free to reach out to us!