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HealthState PPO
HMO
Life InsuranceDentalVisionSupplemental |
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Important Considerations: Choosing a Dental Plan
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Compare the four types of options - PPO, Indemnity, Indemnity with PPO, and Prepaid. |
All four types cover most of the same types of services, but the way they pay benefits is different.
Key Decision Points:
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Access to Care | How you pay for care | Orthodontia benefit |
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Prepaid Dental Plan |
Use network providers to receive benefits; no benefits outside network |
Pay a fixed copayment for dental procedures listed on the copayment schedule. |
Adults and children when you use a network provider |
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PPO Dental Plan |
Use network or non-network dentists and providers … your cost is lower in the network |
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Adults and children when you use a network provider |
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Indemnity with PPO |
Use network or non-network dentists and providers...your cost is lower in the network |
Annual deductible and any amount over the coinsurance amount or the stated dollar reimbursement, up to the annual maximum allowed |
Child only orthodontia covered by Assurant |
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Indemnity |
Use any dentist or dental provider; some provider discounts when you use network provider |
Annual deductible and percentage of cost |
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Check to see which dentists and specialists are available in each plan. |
Many dentists and specialists are in more than one dental network.
- In the chart below, the left column links to the Web sites and the right column offers step-by-step instructions to help make your search easier.
- Keep in mind that dentists enter and leave networks. A dentist in
the network now may or may not be in the network when you schedule
dental services. You cannot change plans because a dentist leaves
the network.
| Dental Plan Adminstrator | Instructions |
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Click on Find a Dental Provider |
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1. Click on Search PPO Dental Providers for Indemnity with PPO Dental plan. |
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1. Click on Find Doctors or Dentists by Specialty and follow
instructions. |
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Click on Search for Providers under the plan name. Schedule B Indemnity plan does not include a provider search; you may choose any dentist. |
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Click on the Dentist Locator |
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Think about your likely dental care needs for the coming year, then compare your total cost for care and coverage under the different options. |
The online Dental Plan Cost Estimator can help you do this. It adds up:
- your estimated out-of-pocket costs for care - based on the types of care you anticipate using
- your cost for coverage … for the dental options you choose
to compare. That way, you can make an apples-to-apples comparison
of your total cost.
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Factor one of the Reimbursement Accounts into your decision. |
The Medical Reimbursement Account and Limited Purpose Medical Reimbursement Account offer tax advantages by allowing you to set aside pre-tax dollars for eligible healthcare expenses - including your dental copays, deductibles and coinsurance. Consider …
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Limited Purpose Medical Reimbursement Account |
Medical Reimbursement Account |
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… if you are enrolling in one of the Health Investor Health Plans for medical coverage |
… if you are enrolling in one of the state's other medical plans or you are not enrolling in any state medical plan. |
You may use a reimbursement account for dental expenses even if you don't enroll in a dental plan.
Use the Reimbursement Account Estimators to see what you might save in taxes - and whether an account makes sense for you.
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Decide which option is best for you. |
Take into account everything you've considered in Steps 1 - 4. Complete this process and enroll your decisions.
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