What Is Indemnity Dental Insurance And How Does It Work?

Dental Health
By: Spirit Dental
April 30, 2015

A person calculating dental costs and coverage

Updated July 2021

When you are in the market for dental insurance, it is easy to become overwhelmed by the different choices that are available. However, there are a few simple concepts that make this process a lot easier to understand. Keeping these in mind will help you find an affordable policy for your or your family.

There are two main types of dental insurance: managed care and fee-for-service. Indemnity dental insurance is a type of fee-for-service plan that lets you see any dentist you wish. However, your insurance company only pays for care after you submit a claim.

This means that you have to pay for the cost of care upfront, and then send your claim to your insurer for reimbursement. This means that your out-of-pocket costs will be higher, and you may not always get as much back as you think that you should.

A dentist has a fee schedule that determines how much he charges for any particular procedure. This schedule is in part controlled by the costs that are "usual" and "reasonable" for a particular procedure. How much the insurance company will pay for each procedure is determined by what is "customary." This is the concept of "UCR" fees.

Before you have any work done on your teeth, it is a good idea to complete a pre-claim form. This will tell you both how much the dentist will charge for doing the work, and how much your insurance company will reimburse you. This way, you will be less likely to be surprised and discover that you get less back than you thought you would.

It is also important to remember that fee schedules are often updated on a regular basis, so you need to be aware of the current fees. Be sure to ask before you see a dentist. Do not just assume that the fee you paid last year for a procedure still applies.

However, indemnity dental insurance has a number of advantages. Its primary advantage for most patients is flexibility. You are not limited to seeing a select group of dentists who belong to a specific network. Instead, you can see virtually any dentist that you wish.

Before you apply for insurance, therefore, you need to understand the strengths and weaknesses of different policies. This way, you can compare these and settle on a policy that is well-suited to your needs. Explore these policy differences and get a quote from Spirit Dental & vision. 

Sources: https://www.thebalance.com/about-indemnity-health-insurance-policies-2645647

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