Direct Reimbursement Plan

Compare the Different Types of Dental Plans

Direct Reimbursement Plan

Brief overview:

Direct reimbursement plans are self-funded plans and not insurance. In this type of plan your employer pays for dental visits with its own money rather than paying premiums to an insurance company.

What you pay:

After treatment, you pay the dentist in full and give the receipt to your employer. Your employer will reimburse you for all or part of the cost, depending on the specific plan design.

Your company may reimburse 100% of the first $100 of dental costs, such as preventive treatments (cleaning) but a smaller percentage of ongoing dental treatment throughout the year.

Advantages Advantages:

Direct Reimbursement plans do not usually have deductibles (a part of the fee that you would have to pay first).

You can choose any dentist you like.

Advantages Be aware that:

Direct Reimbursement plans are not regulated by state insurance departments.

Waiting periods for benefits sometimes apply.

Out-of-pocket expenses are generally higher.

You will usually have to pay the dentist in full for any treatment you receive, and then have to wait for reimbursement of any money owed by the plan.

Dentists are not required to go through the rigorous credentialing process, as those who participate in PPO, EPO and DHMO networks are.

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