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Types of Employee-Sponsored Dental Benefits Plans

By March 3, 2017No Comments

Some employers offer a dental plan as part of the employer benefits package. It can be a beneficial employment perk, so become familiar with the common types of dental benefits as you decide if your company’s plan meets your needs.

Fee-for-Service Dental Benefits

Under this type of plan, the dentist receives a set fee for services. There are five common types of fee-for-services dental benefits plans.

    1. Direct Reimbursement

      This self-funded plan allows you to choose your dentist. Your insurance will directly reimburse the dentist or you pay out-of-pocket, submit a receipt to your insurance and receive a check.

    1. Indemnity Plans

      Also called traditional insurance, indemnity plans allow you to choose your dentist and pay dentists based on the procedures they perform. The dentist determines the fee for each procedure, and your insurance covers a portion of each procedure up to a maximum allowance.

    1. Preferred Provider Organization (PPO)

      Dentists in a PPO plan contract with an insurance company and deliver specific dental services for a set fee. You’ll save money by seeing a dentist in your PPO rather than an out-of-network provider.

    1. Managed Care

      Dental providers may partner with members and provide managed dental care. This care includes dental procedures and financing.

    1. Dental Health Maintenance Organization

      A dental health maintenance organization (DHMO) is also known as a capitation or pre-paid plan. Under a DHMO, your dentist receives a certain amount of money each month. The dentist must then provide services to you at no or a reduced cost. You must visit the covered dentist and will not receive any financial reimbursement for services you don’t use.

Other Types of Dental Plans

In addition to fee-for-service dental benefits, you may choose from several other types of dental plans.
Discount or Referral Dental Plans

    1. The insurance company may contract with a network of dentists who agree to discount their services to members. You pay for treatment you need out-of-pocket according to the fee schedule.
    1. Point of Service Options

      With your managed care dental plan, you may receive treatment from dentists who are not in your network of dental providers. Expect to pay significantly more to out-of-network providers than you would for services from an in-network dentist.

    1. Table or Schedule of Allowances Plans

      A type of indemnity plan, a table or schedule of allowance dental plan assigns a dollar amount to each dental procedure. You must pay the difference between the allowance and the actual charge, and you may need to choose a PPO dentist to receive the maximum benefit amount.

Your employer may offer dental benefits as part of your employee benefits package. Understand which type of plan is offered as you decide if the coverage is right for you.