What does dental insurance reimbursement mean for the employee?

It means employees will have to pay for their dental costs but will later be reimbursed for their dental expenses, typically through a direct reimbursement insurance plan.

Some employers offer direct reimbursement dental insurance plans, also known as fee-for-service or indemnity plans. For these type of plans, an employee will often be responsible for paying the cost of their visit to the dentist and then receive reimbursement later.

How An Employee Gets Reimbursed:

With a direct reimbursement plan, the employee receives service from a dentist and then pays the entire bill. The employee then takes a copy of the bill and submits it to the insurance provider and is reimbursed for the cost. It’s important the employee also sends a receipt of their payment to ensure the reimbursement isn’t sent to the dentist’s office.

The Benefits Of Direct Reimbursement:

Direct reimbursement offers employees plenty of options in terms of dental care services. Unlike many other plans, there are usually no restrictions on the network; employees simply choose the dentist they want. In addition, there are not many restrictions on
treatments.

Additional Implications For Employees:

Most direct reimbursement plans have a maximum limit, typically in the range of $1,000 to $1,500. Many plans will only pay a certain percentage of this maximum as well. For example, an employee might have to pay for 20 percent of their coverage for $1,500 of dental coverage. The percentage covered and the maximum limit is often dependent on what you as an employer have for your direct reimbursement plan.

Helpful Links:

Dental Benefit Information for Employers by the American Dental Association