Dental insurance exists as individual plans, family plans and group plans. Group plans are most likely to be offered at your place of employment. It is less common for employers to offer dental plans to retirees; but the need for dental coverage continues throughout retirement.
There are several categories of dental plans with some overlap between them:
- Traditional (indemnity). A traditional plan lets you see any dentist you want as long as they accept insurance. You must cover a certain amount of the expense by yourself first—the deductible—and then the plan covers a percentage, such as 80%, of the rest of the costs. You must then pay the balance.
- Dental Health Maintenance Organization (HMO). Dental health maintenance organizations set up a network of dentists who agree to charge rates set by the HMO. These are called "in-network" plans. Co-pays may be required. You may receive care outside the network if you wish, but you will have to pay the cost of it yourself.
- Preferred Provider Organization (PPO). Preferred provider organizations set up a network of dentists who agree to charge rates set by the PPO. As with HMOs, these are called "in-network" plans. You may receive care outside the network, of course, but the PPO will cover only the amount that would have been charged if you had stayed in the network. Co-pays may be required.
- Capitation plan. A capitation plan pays a dentist a set amount of money for a specific time period, and pays the dentist regardless of how much treatment you receive.
- Reimbursement plan. This type of plan reimburses you for dental services received. The reimbursement may be paid by the employer or the insurance company. The amount you receive may be the full amount you paid, or it may be a percentage of that. There is usually a maximum amount reimbursable, which resets annually.
- Dental care service plan. This is a non-profit organization that uses a group of dentists who provide dental services at set fees.
Alternatives to dental insurance
If you cannot or do not want to get dental insurance, there are other ways to meet your needs.
- Discount dental plan. A discount dental plan offers discounted prices on many services offered by dental care providers who agree to participate in the plan. They typically do not have annual limits or health restrictions.
- Payment plan. Some dental providers offer payment plans structured like loans.
- Dental financing. There are some finance companies that will extend you a line of credit for dental procedures. These plans work like loans and should be understood carefully.
- Health Savings Accounts (HSAs), Flexible Spending Accounts (FSAs), Health Reimbursement Accounts (HRAs). If you have a flexible spending account or a health reimbursement arrangement from your employer, you can set aside money tax-free to pay for dental needs not paid for by insurance. Health savings accounts offer the same use, and they may be set up at your employer or on your own.
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