Deductibles and Coinsurance
Dental is Important
Limitations and Exclusions
Procedure Classifications
Dental Plan Basics
100

This is the most common type of deductible placed on a dental plan.

Calendar Year 

100

Benefits help employees with financial protection by doing this.

Sharing cost. Large groups will lead to lower premium costs and give employees a financial safety net.

100

These two preventive treatments often have age limitations.

What are fluoride and sealants?

100

Braces and other corrective treatments belong to this classification.

What is Type 4 (Orthodontia)?

100

This type of dental insurance plan allows you to choose any dentist, but often reimburses less if they’re out-of-network.

What is a PPO (Preferred Provider Organization)?

200

Members are required to satisfy the amount of a lifetime deducible this many times.

once

200

Preventative care is most important because it does this to medical claims. 

Lowers Medical Claims

200

This modern form of care may be included as a wellness feature, offering virtual dental consults.

What is teledentistry?

200

Crowns, dentures, and bridges fall under this class.

What is Type 3 (Major)?

200

These plans require patients to choose a dentist from a defined list and often have lower costs.

What is a DHMO (Dental Health Maintenance Organization)?

300

A deducible that is required every office appointment is called?  

per-visit deductible  

300

This is one serious condition your dentist can see before your doctor.

**Heart disease, Diabetes, Pre-mature labor, Cancer

300

Bitewing and panoramic types of this diagnostic tool are often limited in frequency.
 

What are X-rays?

300

This classification includes diagnostic exams, cleanings, and X-rays.
 

What is Type 1 (Preventive and diagnostic)?

300

This type of dental plan reimburses a set amount for each service, regardless of the dentist's fee.

What is an indemnity plan?

400

This percentage-based cost-sharing model is common in dental insurance.

What is coinsurance?

400

These costs are typically reduced when you have dental insurance, making treatment more affordable.

What are out-of-pocket expenses?

400

This limitation may prevent benefits for teeth already missing before the policy began.

What is the missing tooth clause?

400

This classification includes fillings, simple extractions, and some root canals.
 

What is Type 2 (Basic)?

400

Dental plans typically break procedures into these four classifications.

What are Type 1 (Preventive), Type 2 (Basic), Type 3 (Major), and Type 4 (Orthodontia)?

500

Coinsurance for major services is typically this percentage.

What is 50%?

500

 Dental insurance promotes regular visits to the dentist, which can improve this essential aspect of personal and professional life.

What is self-confidence (or your smile/appearance)?

500

These prosthetics often have both frequency and cost limits.

What are crowns/dentures/bridges?

500

Most dental plans use this percentage split for preventive, basic, and major services.

What is 100/80/50?

500

This plan feature limits the amount a person pays before insurance starts paying.

What is a deductible?