Dental Benefits Overview

People with dental benefits visit their dentist more frequently than people without benefits because the cost is shared. Learning about your dental benefits and becoming an educated consumer of those benefits can improve your health and lower your out-of-pocket expenses.

Reasons employers offer a dental plan:

- Dental is a highly valued and utilized benefit program.
- Helps attract and retain employees.
- Employee wellness and oral health care are important.

Differences Between Medical and Dental

	Dental	Medical
Complexity	Mouth	Entire body
Treatment	Predictable, ongoing	Unpredictable, episodic
Cost	Low cost	High cost
Control	Preventable	Not always preventable
Setting	Office based	Hospital and office based
Specialties	8	Over 150
Solo practitioner	75%	10%

Considerations before choosing between dental plans:
- Review your family's dental needs.

- Review coverages (e.g. deductible, co-pays, co-insurance, maximum, limitations and exclusions).

- Review your monthly contributions for the dental plan and your potential out-of-pocket expenses.

- Is your dentist a network provider? What is the impact to your out-of-pocket expenses for using non-network dentists? For more on the cost impact of using network or non-network dentists, see Financial Impact of Using PPO Dentists and PPO vs. non-PPO Dentists.

Types of Dental Benefit Plans

The following chart compares Fee for Service versus Preferred Provider Organizations (PPO) and Dental Health Maintenance Organizations/Exclusive Provider Organizations (DHMO/EPO).

	Fee for Service	PPO	DHMO/EPO
Cost	Highest	Moderate	Lowest
Choice of Dentist	Any dentist	Any dentist	Network dentists only
Network of dentists	None	Large	Small
Dentist discounts fees	None	Yes	Yes (DHMO-Capitation)
Dentists monitored for providing appropriate care (Utilization management)	No	Yes	Yes
Dentists's credentials verified (Credentialing)	No	Yes	Yes