Dental Health Insurance

Indemnity Dental Insurance Plans

Also referred to as a traditional dental health insurance plan, the indemnity dental plan was the first type of dental Insurance available through insurance companies. Claim payments to the insured are made on a "fee-for-service" basis, which means that a set amount is reimbursed based on the type of dental treatment received. The insured must pay the dentist directly and then file a claim with the dental insurance company to receive reimbursement. Some covered dental insurance benefits may have a higher percentage of reimbursement than others. If the amount of reimbursement is less than the covered amount, the insured member will be responsible for the difference.

When determining how much to reimburse for a covered dental insurance procedure, the indemnity dental insurance company will calculate their payment based on usual, customary and reasonable rates. This means that they will have a payment schedule that will show how much a certain dental treatment would reasonably cost based on the service and the geographical location where treatment was rendered. If the dentist charges you more than this customary rate, you will be responsible for the excessive amount.

An indemnity dental insurance plan will usually require you to pay a deductible and/or a coinsurance amount. The deductible is the amount that you must pay annually toward covered dental benefits before you are eligible for reimbursement. Coinsurance is the percentage of the customary rate for which you are responsible. A standard indemnity dental plan might have an 80/20 coinsurance, which means the insurance company will pay 80% of the cost and the insured will pay the other 20%. Most indemnity plans have an maximum annual benefit limits, meaning they will only reimburse you up to a certain amount per year.

Like a PPO dental plan, indemnity dental insurance plans give you the freedom to go to the dentist of your choice. Even if your dentist does not accept dental insurance, the indemnity dental plan will reimburse you for services performed by that dentist if the service is included in the list of covered benefits.

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