Cost sharing is an insurance company practice where a dental plan enrollee is required to pay a portion of the cost for a covered dental procedure (e.g., a filling, a root canal, a crown, etc.). The enrollee’s contribution toward the dental procedure may be in the form of a deductible, a copayment, or a coinsurance fee. These enrollee contributions are out-of-pocket, meaning they are paid only by the enrollee and not the insurance company.
In DPPO dental plans, there is also the matter of the maximum benefit. A maximum benefit is a limit (e.g., $2,500) on how much an insurance company will pay for covered dental care within a single year. Any dental expense exceeding this limit would be paid out-of-pocket by the dental plan enrollee. At the beginning of a new plan year (i.e., new period of insurance coverage), the insurance company’s contributions toward the maximum benefit reset to $0.
Our knowledgeable customer service team will assist you with any questions you may have prior to enrolling in a dental plan. They can guide you through the process of choosing coverage that matches your needs as well as your budget.
