Types of Dental Plans

COVERAGE & SERVICE LEVELS

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Exams and Consultations

As you probably already know, when you first visit the dentist you are given an exam that typically includes x-rays and an evaluation from the dentist. Most dental plans include coverage or discounts for this process.

Preventative Treatment

Though we find that most people dislike having to go to the dentist, frequent care is critical for maintaining healthy oral hygiene and limiting the necessity of serious dental problems in the future. Preventative dental treatment includes repeat exams, cleanings, and deep cleanings. Typically dentists recommend check-up service every six months. This is another standard service that is included in most dental plans.

Basic Dental Service

These treatments mostly consist of cavity fillings, scaling, fluoride, sealants, and other minor restorative care. These services are usually covered and accessible with most dental plans with no waiting period. 

Major Dental Service

This is the level of care that is ordinarily expensive, painful, and the outcome of poor preventative oral maintenance.  Dental plans that include coverage and discounts on major dental services will typically save thousands of dollars versus an uninsured consumer with the same problems. However, most plans can be limited by implementing a 6-12 month waiting period and low annual maximum benefits. A low annual maximum simply means a dollar limit and is commonly found to be $1000.00.

A dental plan that is insurance and includes coverage for ALL four of the above levels is considered Full Coverage. 

Cosmetic Service

Most insurance plans do not include coverage for cosmetic procedures. Because these procedures are considered the most expensive and medically unnecessary, dental insurance companies will almost always deny these claims. There are very few insurance companies that provide some coverage, but they do exist for additional monthly premiums. 

How soon can I go to the dentist after enrolling in a plan?
The effective date is the date a dental plan is available for use. The earliest effective date caries depending on the dental plan or dental insurance company. However, since we are independent and offer multiple options we have dental plans that can be used within 24 hours of enrollment. Call us for assistance.

What if I am not satisfied with the dental plan I enrolled in?
All of our plans have a 30-day money back satisfaction guarantee. Simply call the dental insurance or plan company you enrolled with and you will receive a full refund, no questions asked. Please see our Refund Policy for more information. 

There are many insurance companies and plans to choose from. How do I know which are legitimate if I do not recognize them by name?
Dental plan and insurance companies are usually national and there are many different variations of partnerships, network arrangements, and associations that are operating in direct and indirect markets, etc. Though complicated, we'll keep it simple by suggesting to always make sure the company that is providing your coverage or discounts has been established for many years or is working with a company that has. The easiest way to determine this is to identify the network of dentists they are affiliated with because a dentist will not contract with a phony company! Luckily, we are available when you are ready to help de-complicate tiresome searching process.

I just enrolled in a dental plan and I am shocked and unhappy that the coverage and benefit payouts are less in the first year of coverage. Why is that?
Get use to it! There is no way to sugar coat the fact that the dental insurance companies are often considered "skimpy" during the first year. Though it can be disappointing to have an emergency dental problem that is not fully covered by a last minute plan purchase, the dental insurance companies could not survive if members only bought coverage when they had an accident. Long story short, it's basic math. Fortunately there are some companies and plans that pay more than others and will still save you hundreds or thousands of dollars depending on the care during the first year. Discount plans can also be a good option for certain individuals. But ultimately, the best approach is to find and keep a dental plan from a reputable company that has high annual maximums, benefits that increase over time, locked rates, and uses a national well-known PPO network. Because pretty much all dental insurance plans become the most comprehensive the longer you keep it and the long term savings drastically outweighs the short term benefits of enrolling, using, and cancelling. 

PPO (PREFERRED PROVIDER ORGANIZATION) DENTAL PLANS

PPO dental plans are generally the best dental insurance plans available, offering a compromise between lower costs and choosing the dentist you wish to visit. Choosing PPO dental coverage generally results in the lowest expenses when you visit a PPO dentist, but your dental treatments will still be covered according to your plan agreement should you choose or need to visit a dentist outside the network. There are huge networks of PPO dentists across the country, so finding one to suit you is easy, and many participating dental practices will bill your insurance directly for your care and treatments, so you pay only your copayment, rather than paying the full amount and waiting for reimbursement. PPO dental coverage usually covers varying levels of treatments at different rates - for example you may only pay 20% of the full bill for preventative treatments, but 50% for more specialized treatment - but they generally offer the most comprehensive coverage for your dental care.

HMO (HEALTH MAINTENANCE ORGANIZATION) DENTAL PLANS

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Often referred to as DHMO or pre-paid plans, HMO dental plans are a common choice for dental insurance in the USA. They generally require you to choose one specific dentist to take care of all your dental health needs, or those of your family. When specialist care is required for your teeth or gums, your dentist may refer you to another office, but in many cases the specialty care may require preauthorization from your HMO. While many basic diagnostic or preventative treatments are entirely covered and require no copayment at all, HMOs rarely cover treatment by a dentist other than your regular dental network. This means that if you require specialist care, or have a dental emergency while away from home, you can be on the hook for the entire bill, which can be an expensive and unpleasant surprise on top of the need for dental care.

DISCOUNT (OR REDUCED-FEE-FOR SERVICE) DENTAL PLANS

While many people refer to these service plans as dental plans, they are not, in fact, insurance at all. Discount dental plans require you to pay a monthly or annual fee and simply offer access to dental services and treatments at a reduced rate when you visit participating dentists. While there are no limits, deductibles or insurance forms to fill out, this is simply because you do not actually have insurance. Discount plans are only valid at your participating dentist, and often charge patients for a greater portion of their dental treatments than PPOs or HMOs. Specialist and emergency treatment are generally not available on discount dental plans.