Understanding the various types of individual dental insurance and family dental insurance plans is important when trying to buy the right plan for you and your family.  Finding the right value in individual dental insurance or dental plans is an important step in purchasing dental coverage for you and your family.

The different  types of individual dental insurance plans have advantages and disadvantages and one size does not fit everyone. Keeping this in mind is an important rule when you shop for the dental plan that best fits your needs.

Indemnity – Individual Dental Insurance

This is the plan where you choose your own individual or family dentist. The dental insurance plan pays the dental office on a traditional fee-for-service basis. A monthly premium is paid by the client and/or the employer to an insurance company, which then reimburses them for the services rendered.

A dental insurance company usually pays between 50% – 80% of the family or individual dental office fees for a covered procedures; the remaining 20% – 50% is paid by the client. These plans often have a pre-determined or set deductible amount which varies from plan to plan. Indemnity dental plans also can limit the amount of services covered within a given year and pay them based on a variety of fee schedules.

 Preferred Provider Organizations

Another true dental insurance plan, a Preferred provider organizations ( PPO) falls somewhere between an indemnity plan and a dental HMO. This plan allows a particular group of patients to receive dental care from a defined panel of individual dental insurance dentists. This type could be used to provide dental gap insurance.

The participating individual or family office agrees to charge less than usual fees to this specific patient base, providing savings for the plan purchaser. If the patient chooses to see one who is not designated as a “preferred provider,” that patient may be required to pay a greater share of the fee-for-service.

A group of individual or family dentistry providers agrees to provide services at a deeply discounted rate, giving you substantial savings — as long as you stay in their network. Unlike the more restrictive DHMO, though, you can go out of network and still receive some benefits.

HMO Insurance Networks

DHMO refers to a dental health maintenance organization that helps you find the best…

These insurance plans, also known as “capitation plans,” operate like their medical HMO cousins. This type of dental plan provides a comprehensive dental care to enrolled patients through designated provider office.

A Dental Health Maintenance Organization (DHMO) is a common example of a capitation plan. The individual and family dentist is paid on a per capita (per person) basis rather than for actual treatment provided.

Participating individual and family dental offices receive a fixes monthly fee based on the number of patients assigned to the office. In addition to premiums, client co-payments may be required for each visit.