With an indemnity dental insurance plan, you can choose your own dentist
An indemnity dental insurance plan is often called a traditional dental coverage plan or a fee-for-service plan. In this type of dental insurance plan, you have the option to visit any dentist or dental care professional you wish. You do not need to select your dentist from a list of network providers or approved providers to qualify for benefits and coverage. You will need to pay a deductible on your indemnity dental insurance. After you have done so, your insurance provider will cover a part of "usual and customary" dental costs. How much your dental insurance will reimburse you will vary according to your provider. However, many insurance providers offering this sort of plan will pay for 80% or even 100% of "usual and customary" dental costs.
Features of a fee-for-service dental plan
There are several features of indemnity dental insurance plans for individuals that make these plans different from many other types of dental coverage:
1. Insurance providers will pay up to 100% of preventative dental care. Typically, this includes regular checkups and cleaning. Many providers will also pay between 50% and 80% of "regular and customary" dental costs. These costs may include fillings, root canals, and other basic dental work. Check your policy to find out exactly what your plan does and does not cover.
2. Much of indemnity dental plan insurance benefits center around the term usual and customary. In general, only these treatments are covered by the dental insurance, and as can be expected, what providers consider to be "usual" and "customary" varies widely. You will need to read the fine print of the policy your provider sends to find out what is and what is not covered.
3. There is often a maximum benefit amount for dental benefits with this type of coverage. If you require treatment beyond this limit, you will often be responsible yourself for these costs. It therefore makes sense to find a policy that has a high limit.
4. These dental insurance plans make use of a UCR fee schedule. These schedules are tables that your dental coverage provider uses to determine how much to pay you for specific services. These can dramatically affect how much reimbursement you get. For example, if your dentist charges higher fees for services than your dental coverage provider's UCR fee schedule indicates is common, then your provider will give you less money for the procedure, leaving you to pay more for the bill.