Types of Individual Dental Insurance

If you’re on an employer-sponsored health insurance plan that doesn’t include dental benefits (or does include dental benefits, but they’re too costly or don’t cover the needs of you and your family), consider purchasing an individual dental insurance plan. When you purchase individual dental insurance, you can keep any additional medical insurance you’re already using and supplement it with a dental insurance policy. 

Individual dental insurance can be purchased directly from a private dental insurance provider. This type of insurance allows you to compare different plans and choose the one that works for you based on your requirements and the costs you’re willing to incur. 

Since dental insurance plans vary, so do the portion of fees the carriers cover and the reimbursement levels they offer. Remember to read the fine print when looking for a new plan. 

Types of Individual Dental Insurance

There are two main types of individual dental insurance available in the marketplace:

You may have multiple choices when choosing an individual dental plan. You can select the type of plan and the coverages that will work best for your unique situation and your budget. There are two main types of individual dental plans you can purchase:

• Dental Health Maintenance Organization Plan (DHMO)
• Dental Preferred Provider Organization Plan (DPPO)

DHMO vs. DPPO Plans

While DHMO plans generally have lower out-of-pocket charges, they require you to choose a primary dentist within their network. If you want to see a specialist, these plans require a referral.

On the other hand, DPPO plans allow members to choose from a wider group of dentists and still receive treatment coverage. However, the costs associated with these plans are generally higher than those associated with DHMO plans. 

To determine which of these individual dental insurance plans is best for you, consider whether it more important to choose from a broader range of dentists and providers or to keep your costs as low as you can get them.

What Does Individual Dental Insurance Cover?

The services covered by individual dental insurance plans depend on the type of plan you choose and the carrier that provides the coverage. Unlike medical insurance, it’s easier to keep track of which services are covered and the costs for each since there are much fewer categories to cover. 

While you’ll need to check the fine print of your specific plan to learn more about all the services and treatments it covers, most policies cover anything that falls under preventative care, diagnostic services, and restorative and major services. However, the percentage of coverage and reimbursement rates for these may vary.