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Dental insurance can reduce your out-of-pocket costs for preventive care, basic services and major procedures. Many dental insurance plans partner with a network of dentists who agree to pre-negotiated rates. While some plans still allow you to visit dentists outside of the network, it typically costs more. Understanding how in-network vs. out-of-network dental care works can help you manage your dental care expenses and choose the right plan.
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In-network dentists are providers who have agreed to set rates with your insurance company. These negotiated prices are usually lower than their out-of-network rates, helping you reduce your out-of-pocket costs.
With DHMOs, you must visit an in-network dentist to receive coverage. Even when it’s not required, staying in network can often save you money. It can also reduce your paperwork, since in-network providers typically handle claims on your behalf.
Out-of-network dentists don’t have a contract with your insurance provider. As a result, they set their own rates, which are often higher than those of in-network providers.
Some types of dental insurance, like DPPOs, may still offer partial coverage for out-of-network care. In these situations, you typically need to pay up front and submit a claim to your insurer. Your insurer will base your reimbursement on a predetermined amount, leaving you responsible for any remaining balance.
Don’t wait until it’s too late. Protect yourself and your family with coverage from Aflac.
Get StartedBefore choosing a dentist, it’s important to consider how their network status may affect your dental care costs and overall experience. You can do so by evaluating the following factors:
Finding an in-network dentist is simple. You can do so by:
Even though out-of-network dentists often cost more, there are situations where they may better meet your needs, such as when you:
Having the flexibility to choose your provider can be valuable. However, selecting an insurance plan with a strong network can help you manage your dental care costs more effectively over time.
Yes, DPPO plans may offer partial coverage for out-of-network care. However, you may need to pay up front and submit a claim for reimbursement. Your out-of-pocket costs may also be higher.
In most cases, yes. Out-of-network dentists set their own fees. Your insurance may cover a portion of the cost and leave you responsible for the difference.
No. While DHMO plans typically require you to visit in-network providers, DPPO plans often allow you to see out-of-network dentists at a higher cost.
Understanding the differences between in-network vs. out-of-network care can help you avoid unexpected costs and choose the right dental insurance plan for your needs.
At Aflac, our dental insurance for individuals and families can help you save on dental care while giving you the flexibility to see both in-network and out-of-network providers. Chat with an agent today to learn more and get a quote.
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Having some type of cost-efficient dental plan, like the ones offered at Aflac, can help you avoid the high fees that may come from buying dental care without insurance.
Dental insurance can save you money on dental care. Learn how it works, what it covers, and how to get a dental insurance plan.
Having some type of cost-efficient dental plan, like the ones offered at Aflac, can help you avoid the high fees that may come from buying dental care without insurance.
Dental insurance can save you money on dental care. Learn how it works, what it covers, and how to get a dental insurance plan.
Content within this article is provided for general informational purposes and is not provided as tax, legal, health, or financial advice for any person or for any specific situation. Employers, employees, and other individuals should contact their own advisers about their situations. For complete details, including availability and costs of Aflac insurance, please contact your local Aflac agent.
Dental, Vision, and Hearing coverage is underwritten by Tier One Insurance Company. Tier One Insurance Company is part of the Aflac family of insurers. In California, Tier One Insurance Company does business as Tier One Life Insurance Company (NAIC 92908).
Dental, Vision and Hearing: In Delaware, Policy T80000. In Idaho, Policy T80000ID. In Oklahoma, Policy T80000OK. Dental claims are administered by SKYGEN USA, LLC. Vision claims are administered by EyeMed Vision Care, LLC. Hearing claims are administered by Nations Hearing. NOTICE: The coverage offered is not a qualified health plan (QHP) under the Patient Protection and Affordable Care Act (ACA) and is not required to satisfy essential health benefits mandates of the ACA. The coverage provides limited benefits.
Coverage may not be available in all states, including but not limited to NJ, NM, NY, VA or VT. Benefits/premium rates may vary based on state and plan levels. Optional riders may be available at an additional cost. Policies and riders may also contain a waiting period. Refer to the exact policy and rider forms for benefit details, definitions, limitations and exclusions.
Aflac WWHQ | Tier One Insurance Company | 1932 Wynnton Road | Columbus, GA 31999
Z2500892
EXP 10/26
