Dental Coverage by Class of Service

The amount of dental reimbursement a dentist receives usually depends on the type of service he or she has performed on the patient. This is known in dental plan terminology as “class of service,” which ranges from Class I to IV. The more extensive the dental treatment was, the less the coverage will be for the dentist. Class I pertains to diagnostic and preventive care. Regular checkups, cleanings, and dental x-rays are usually fully reimbursed.

Class II includes basic restoration; dental plans usually cover 80 percent of the cost of root canal and periodontal work. Class III involves advanced restoration procedures such as installing crowns and dental implants, and plans usually shoulder half of the cost. Finally, Class IV, which isn't a regular in dental plans, covers braces. The cost of orthodontic care is separate from a dentist's annual limit, but patients under 19 years of age may only be eligible for this type of reimbursement.

Keep in mind that most dental plans won't cover you for the whole year, as they usually set a number on the frequency of exams. They can only cover so many preventive care exams before dentists have to wait for next year for reimbursement. Dental plans also include time limits on certain services such as the replacement of prosthetics and orthodontics.

All About Dental Reimbursement and How it Works

A dental treatment can be an expensive service. Its cost may vary depending on the level of difficulty or the expected effect of the method used. Basic treatments like extraction and filling are among the least expensive, next to preventive dental exams. Unfortunately, many still find the prices steep and thus refuse to get professional treatment.

Fortunately, there is such a thing as direct dental reimbursement. This is an innovative solution to helping employees get discounts or reimburse cash when they get certain dental treatments as a form of self-funding benefit. It gives the employees the freedom to choose the dentist they want, especially if these dentists aren't among those authorized to provide services through their company-funded dental benefits.

Direct dental reimbursement is popular for its simplicity. It comes with a set of dental plans allowing clients to choose their dentists, pay their bills, and get their reimbursements. Usually, the payment for the benefits are assigned directly to the client's chosen dental office, making it easier to receive.

Unlike traditional dental plans that are based on the type of treatment received, direct dental reimbursement is based on dollar expenditures. Meaning, the client doesn't have to look for dental offices that provide the treatment he needs least or more expensively to get a favorable reimbursement. Clients can also expect very few limitations on the benefits they will receive.