How does my company decide which dental plan is best for us?

The best network and plan will have providers in your area who offer the services you need within an affordable plan. So finding the one that’s best for you will satisfy the following four key factors:

Services Required

Basically, you must decide what dental services you want your insurance to cover. There are Dental HMO-style plans as well as Dental PPO-style plans. The DHMO is lower in cost because all of the services have preset copays and will require a primary care provider to get access to all care as there is no out-of-network coverage. The Dental PPO category has a wide array of plan options that do not require a primary care provider and that allows wider choice in terms of visits to specialists as well as coverage for out-of-network visits.

Availability of Providers

Offering a strong network of providers that are located in close proximity to your employees is very important. This can turn out to be a geographical issue as much as a financial or needs-based decision. Your network should have providers convenient to your employees for them to be of service. Narrow down your choices to those that have a quality network nearby.

Cost

Regarding price, the types of dental plans available to you will have as much bearing on this as the services that your plan will cover. This is another reason why that availability step above was so important. If your employees wind up having to go out-of-network for the care they need, the cost of that care goes up sometimes considerably.

Plan Types

You can expand the number of providers available to you by opting for coverage that allows out-of-network care, such as with a PPO (Preferred Provider Organization) or an indemnity plan. Be aware though that as availability goes up, so does the cost, which means you’ll end up paying higher out-of-pocket expenses. A DHMO (Dental Health Maintenance Organization) will generally offer the lowest co-payments, but that comes with the limitation of having to stay strictly within your plan’s network of providers.

Helpful Links:

Healthcare.gov Dental Coverage in the Marketplace – This is a useful website to find out how you can get dental coverage in the Health Insurance Marketplace.