Guide to Dental Insurance

It’s no secret that times are tough. Most budgets are tight, and making ends meet in this economy is becoming harder and harder. People are pinching pennies and allotting money where they deem best fit. Unfortunately, this means regular check-ups with Primary Care Physicians and Dental Care Providers have taken a back burner, becoming a rather frightening epidemic. As this trend is on the upswing, it’s important that you know seeing your physicians (primary and dental) on a regular basis, as well as for emergencies, does not have to break the bank. There are many dental insurance plans and programs available to you to help alleviate costs on your end. Sorting through these plans and programs may be a little intimidating, so we have taken the liberty of giving you a general synopsis of common plans, including CareCredit, to help you figure out what works best for you and your budget, without neglecting your health.

Traditional dental insurance plans (may be known as Indemnity plans)

These types of dental plans pay the dental office (dentist) on a traditional fee-for-service basis. A monthly premium is paid by the client and/or the employer to an insurance company, which then reimburses the dental office (dentist) for the services rendered. An insurance company usually pays between 50% – 80% of the dental office (dentist) fees for a covered procedures; the remaining 20% – 50% is paid by the client. These plans often have a pre-determined or set deductible amount which varies from plan to plan. Indemnity plans also can limit the amount of services covered within a given year and pay the dentist based on a variety of fee schedules. Some typical features of these plans:

 High deductibles before coverage begins (well-designed plans don’t apply the deductible to preventive services)

 Probationary periods on certain procedures that last up to a year

 Annual dollar limit on benefits

 Choose your own dentist

 Your average monthly cost: $15 to $25

 Companies selling these plans are regulated by state insurance departments


Dental HMOs

These insurance plans, also known as “capitation plans,” operate like their medical HMO cousins. This type of dental plan provides a comprehensive dental care to enrolled patients through designated provider office (dentist). A Dental Health Maintenance Organization (DHMO) is a common example of a capitation plan. The dentist is paid on a per capita (per person) basis rather than for actual treatment provided. Participating dentists receive a fixes monthly fee based on the number of patients assigned to the office. In addition to premiums, client co-payments may be required for each visit. Some typical features of these plans:

 Monthly premiums (some require you to prepay a year’s worth)

 Co-payments for office visits

 Free preventive or routine care

 You must select from an approved network of dentists

 May have an initial enrollment fee

 Annual dollar cap

 Your average monthly cost: $5 to $15

 Companies selling these plans are regulated by state insurance departments.


Preferred Provider Organizations

Another true insurance plan, a Preferred provider organizations ( PPO) falls somewhere between an indemnity plan and a dental HMO. This plan allows a particular group of patients to receive dental care from a defined panel of dentists. The participating dentist agrees to charge less than usual fees to this specific patient base, providing savings for the plan purchaser. If the patient chooses to see a dentist who is not designated as a “preferred provider,” that patient may be required to pay a greater share of the fee-for-service. A group of dentists agrees to provide services at a deeply discounted rate, giving you substantial savings — as long as you stay in their network. Unlike the more restrictive DHMO, though, you can go out of network and still receive some benefits. Some typical features of these plans:

 Monthly premiums

 Annual dollar cap

 You must stay within the approved network of dentists or pay higher deductibles and co-payments

 Your average monthly cost: $20-25

 Companies selling these plans are regulated by state insurance departments.

(Our Office Participates with PPO Plans Only)

Dental Discount Programs

(This type of dental plan is not insurance)



CareCredit cards are becoming a great way to take care of your health and dental needs, with, or without insurance.

What is CareCredit?

CareCredit is like a credit card, but for health and dental services.

Why use CareCredit and not a regular credit card?

With CareCredit, you won’t have teaser rates, introductory rates, application fees, or pre-payment penalties. You just receive special financing every time you useCareCredit. You only use CareCredit for healthcare procedures. No teaser rates. No introductory rates. No application fees. No pre-payment penalties. Just Special Financing every time*. Use your cash and major credit cards for other expenses and finance your procedure with CareCredit. The credit card just for healthcare.**

Do all providers allow the use of CareCredit?

No. Just like Dental HMO’S and Preferred Provider Organizations, not all dentists allow CareCredit. Dr. Mitchell does accept CareCredit. To find more information on CareCredit, visit Again, as this is quite a bit of information to take in, so if you’re still not sure what is the best fit for you and your family, contact your company’s HR department, ask your insurance company and then contact us to schedule an appointment!