Dental Coinsurance Provisions Explained

The term “dental coinsurance” refers to a type of rule that can be found in some, but not all, types of dental plans. This rule means that when you have this type of plan, you will have to pay a part of the cost of work that is covered by the plan. The plan will not pay for the full cost of your dental work. The part of the cost for which you are liable is most often some share of the total cost of the work that needs to be done.

Case in point: with some plans, the carrier must cover 80% of the cost of work, and then you will have to pay for the 20% that is left. On the whole, the higher the dental coinsurance, the lower the premium you will have to pay.

Dental coinsurance is more often found in a type of plan that is called a preferred provider organization (PPO). They are found less often in a dental health maintenance organization (DHMO) type of dental plan.

Dental Coinsurance and You: What to Look for in a Dental Plan

If you think you may like to sign up for a plan that has this type of clause, it would be wise for you to put in the effort to know what the plan says in detail. This is true since the terms differ from plan to plan. For example, a dental plan may cover all of the fees for one type of dental work until the costs reach $500. After that, the plan will take on 80% of the costs up to $3,000. These types of high and low limits are vital to bear in mind to help you find the best deal.

It is likewise a good idea to be aware of the deductible for a plan you think you may like to join. This is the fee you must pay before the plan kicks in to cover the cost of any work. A dental plan with a $100 deductible, for instance, requires that you pay the first $100 in annual dental costs. After that, the plan will kick in to pay for the work you have done so long as the work is, in fact, covered by the plan.