Group Dental Insurance: What It Is and How It Works

Shawn Plummer

CEO, The Annuity Expert

Group dental insurance, similar to group health insurance, is a type of coverage usually offered by an employer. It helps to pay for dental care for employees and their families. In most cases, group dental insurance is less expensive than purchasing coverage. Let’s take a closer look at what group dental insurance is and how it works!

What Is Group Dental Insurance?

Group dental insurance is an employee insurance policy that helps cover dental care costs. It typically includes coverage through a licensed dentist for preventive care, such as regular checkups and cleanings, and major services like fillings and crowns. Employers can offer Group dental plans as part of a benefits package or purchase independently from an insurer. In most cases, you pay a monthly premium to access the covered services and then pay out-of-pocket costs for any services you receive.

Group insurance can help make dental care more affordable by reducing out-of-pocket costs. It also encourages preventive care and better health outcomes since it usually covers all or a percentage of routine checkups and cleaning costs. If you have a large family or are trying to save money on dental care, group insurance can be a great way to get the needed coverage.

Group plans typically require that you use an in-network provider for services and may place limits on the type of care that is covered. Therefore, it’s essential to read your plan documents carefully to understand what covered services are included and what aren’t covered. If you have questions, contact your insurer or employer for more information.

How does Group Dental Insurance Work?

Dental insurance for groups of employees works like group health insurance, with the employer paying a part of the premiums as part of a benefits package. Then employees take care of the rest with payroll deductions. The services covered usually included dental cleanings, x-rays and exams (preventative), and treatments such as fillings or crowns (diagnostic and therapeutic). Based on the plan, more costly procedures like bridges or dentures (major services) might also be covered under group dental Insurance. Some plans may include orthodontic treatments too.

Most group insurance plans only cover dental services if the member visits an approved provider from the plan’s participating dentist network. This includes both an in-network dentist and an out-of-network provider. Sometimes, employers offer additional dental benefits like discounts on products and services. Because each employer has different features for their respective plans, potential subscribers must learn about the specifics of their coverage before enrolling with a particular group policy.

In certain instances, employers can adapt their group insurance plans to fit the needs of their employees better. For example, they could offer more coverage for unique services like cosmetic dentistry or increase the number of dental providers in the network. Employers might also be able to add riders that cover preventative treatments such as fluoride treatment or sealants. However, it is essential to note that these customized dental benefits usually cost extra.

Group dental insurance generally allows employees to get high-quality dental benefits and feel confident that their treatments will be covered. However, before choosing a plan, subscribers must look at each option’s features and benefits to pick the one that best meets their needs. By taking this step, they can ensure they are getting an economical plan with the level of coverage required.

Group Dental Insurance

What are the Different Types of Group Dental Insurance?

Dental insurance plans often describe dental services in three classifications of service:

  • Classification 1: Preventative and diagnostic services
  • Classification 2: Basic restorative care
  • Classification 3: Major restorative care

When considering a dental insurance policy, ensure it provides comprehensive coverage for preventive, basic, and major services. This way, you can be confident you’re receiving the best quality care possible without breaking the bank.

What is a Preventative and Diagnostic Dental Care Procedure?

Dental procedures such as routine cleanings and exams, X-rays, and cleanings targeted at stopping dental issues before they become more significant are considered preventive. Instructing on brushing and flossing properly is also often given to patients to prevent future tooth decay.

What is a Basic Restorative Dental Procedure?

When requiring restorative work, such as fillings, you now require basic dental plan coverage instead of only preventive care. Always remember that preventive care helps to stop potential problems or correct them early so that your oral health is on the right track; basic services are used to fix the damage.

What is a Major Restorative Dental Procedure?

Dental procedures like implants, which are more complex, are classified as major dental procedures. For these procedures, youth will need major restorative dental coverage. These procedures usually take a long time to address issues that could have been prevented with earlier care. In most cases, if a procedure requires anesthesia or surgery—or is an orthodontic procedure—it will be considered a major dental service.

What is a Dental Health Maintenance Organization (DMHO) Insurance Plan?

DHMO dental plans help you save money by preventing problems. With a DHMO plan, you will know how much money you need to spend before getting any treatment. Most DHMO plans do not have rules that exclude people with previous conditions or missing teeth like some other insurance providers might.

Selecting a DHMO means visiting one chosen dental facility for a large part of your oral health requirements. If you ever need to see a specialist, the dentist at your designated primary facility will give you a referral. All dentists caring for you must be in-network with your personal DHMO plan; otherwise, insurance won’t cover it.

A DHMO plan is a type of dental insurance. Some benefits of this plan are that it has lower premiums than other types of dental insurance, no deductibles, and set copayments. This means that you will pay less money overall for your dental care.

Although having a DHMO has some advantages, such as lower monthly premiums, there are also some drawbacks. For example, the size of the dentist network may be smaller than other dental insurance plans. In addition, you may need to get referred by a primary care dentist to see specialist care. Additionally, out-of-network dental costs usually aren’t covered under this type of plan, and there may be restrictions on visits or treatments that are covered.

What is a Preferred Provider Organization (PPO) dental insurance plan?

Although dental PPO plans have higher out-of-pocket costs, they offer more freedom to choose your dentist or dental facility.

A dental PPO plan will have more dental providers, and you can see a specialist without getting a referral from your primary care dentist. You don’t have to choose a primary care dentist when you enroll in a PPO dental plan.

If you are considering getting a PPO dental plan, remember that you will have to pay more monthly, and you might have to pay for some dental service work yourself before the insurance kicks in. Also, most PPO dental plans only cover a certain amount of dental work per year.

Some of the benefits of a PPO plan type include greater overall flexibility when selecting a licensed dentist or dental facility, a referral is not required to receive treatment from a specialist, Depending on the plan you choose, you may be partially reimbursed for treatment by an out-of-network dentist.

Although PPO plans have some benefits, there are also several drawbacks. These can include higher premiums than a DHMO plan, the presence of a deductible, copayments that might be higher with a PPO dental plan as opposed to a DHMO plan, and an annual limit on coverage in most cases.

What Is Group Dental Insurance

What is the difference between a Dental Health Maintenance Organization (DHMO) and a Preferred Provider Organization (PPO) dental insurance plan?

The primary difference between Dental Health Maintenance Organization (DHMO) and Preferred Provider Organization (PPO) plans is that DHMO insurance typically covers dental services with little to no copayments. At the same time, PPO offers a balance of low-cost care and more freedom to choose your dentist.

Both DHMO and PPO dental insurance plans have their own benefits, features, and limitations that may appeal to different types of people. By understanding how each plan works, you can make a more informed decision about which is right for you.

How do I Get Group Dental Insurance?

Dental insurance through your employer is usually the best option: group rates are lower because the company buys benefits for many employees at once. Group plans often have higher coverage levels, and sometimes the company pays part of the costs.

The first step to getting group dental insurance through your employer is talking to the company’s Human Resources department and seeing if they are offering group dental insurance. They will give you information on the plan’s different coverage levels, costs, and any requirements needed to be eligible.

A private dental insurance company can sell dental insurance to self-employed people or workplaces that don’t provide group plans. Most individual plans have narrower dental coverage than group plans and probably won’t cover your problems before buying the policy. Nevertheless, an individual policy might be a good choice if it meets your particular oral health needs.

Researching different policies can be overwhelming, but it is worth finding the right one. Compare dental plan coverage levels, deductibles, and premiums between options, and make sure to read the fine print before signing up for a dental plan. That way, you’ll know exactly what your policy covers (and doesn’t cover) from the start.

Is a Group Dental Insurance Policy Worth Purchasing?

Group dental insurance policies can offer several benefits to those who purchase them. These policies are typically more affordable than individual plans, making it easier for you and your family or business associates to get the coverage they need. Group rates usually allow you to save money when compared with individual policies. Additionally, group plans often have increased flexibility, allowing you to customize the coverage that best suits your needs.

Next Steps…

Dental health is important! A group dental insurance plan can be a great way to get quality dental care at a fraction of the cost. We have various plans that will fit your needs if you want dental and vision insurance. Contact us today to learn more about our group dental insurance plans and how we can help you get the best care for you and your family.

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Shawn Plummer

CEO, The Annuity Expert

Shawn Plummer is a licensed insurance agent and annuity broker with over a decade of first-hand experience. Since beginning his journey in 2009, he has been pivotal in selling and educating about annuities and insurance products. Still, he has also played an instrumental role in training financial advisors for a prestigious Fortune Global 500 insurance company, Allianz. His insights and expertise have made him a sought-after voice in the industry, leading to features in renowned publications such as Time Magazine, Bloomberg, Entrepreneur, Yahoo! Finance, MSN, SmartAsset, The Simple Dollar, U.S. News and World Report, Women’s Health Magazine, and many more. Shawn’s driving ambition? To simplify retirement planning, he ensures his clients understand their choices and secure the best insurance coverage at unbeatable rates.

The Annuity Expert is an independent online insurance agency servicing consumers across the United States. The goal is to help you take the guesswork out of retirement planning and find the best insurance coverage at the cheapest rates

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