When you’re choosing between different types of dental insurance, the technical terms can sometimes seem overwhelming. One of the types of coverage that you might see mentioned is “dental indemnity insurance.” Here’s what you need to know about this type of a policy:
An indemnity plan is a traditional form of insurance. Your plan will cover certain procedures at different reimbursement levels, but you’ll still be responsible for paying any annual deductibles or for treatment that goes over your annual maximum allowable expenditures.
As an indemnity enrollee, you’ll be responsible for paying for all your treatment at the time of service. You or your dentist can then file the insurance claim with your insurance company. Once the claim is processed, a check is sent to you (the patient) for reimbursement on eligible services.
The advantages of indemnity plans include:
You Can See Any Dentist
The reason so many people choose indemnity insurance plans is because it gives you the freedom to choose which dentist you want to go to…rather than have your insurance company tell you who you’re allowed to see. Plus, you don’t need to seek out a referral in order to see a specialist. If you want to get an orthodontic consultation or talk to an oral surgeon about having your wisdom teeth removed, you can. You don’t have to see your general dentist first and then get a referral form, as you do with dental HMO insurance.
Procedures are Covered at Different Percentages
As with all dental insurance, you’ll have some out-of-pocket expenses to keep up with, such as copays or deductibles. The way an indemnity plan works is that they provide tiered reimbursement — a dental cleaning may be covered at 100%, but a crown may only be covered at 50%. This is standard practice for all types of dental insurance and is intended to encourage you to take advantage of preventive services rather than waiting until problems become complex – and costly.
Getting a Predetermination Before Treatment Starts
For an estimate of what is or is not covered, you will need to have your dentist file a “predetermination” (treatment plan with estimate) prior to treatment being started. Your insurer will then send a “pre-claim” back so that you can estimate how much the total work will cost in total, as well as what you’ll be paying out of your own pocket. A waiting period may be required for certain types of treatments, typically restorative care such as crowns and bridges if you’ve recently enrolled in the plan.
Your dentist can provide you with an estimated cost of treatment, based on what insurance plan you carry and your dentist’s fee schedule. It’s important to note that the indemnity plan will base coverage based on what they deem as “usual, customary, or reasonable” on their own terms, not the actual fees charged by your dentist.
Get Predictable Dental Coverage From Cigna
Cigna dental savings plans provide many of the advantages of traditional dental indemnity insurance. But with a dental savings plan, there are no waiting periods before you can get treatments, no maximum spending limit, and no need to get approvals before beginning treatment. To find out more about Cigna dental savings plans, call 1.844.653.6401