What is fee for service dental insurance?

Fee for service dental insurance can be summed up in three words: freedom of choice. Direct reimbursement (DR) programs are the standard fee for service dental insurance plans. These plans reimburse you for a certain percentage of the money you spend on dental care, no matter what type of care it is. This percentage is predetermined when you sign up for the plan. While these plans do not limit which dentists you can go to and what type of care you are covered for, it does encourage you to negotiate a reasonable price for procedures with your dentist.

Fee for Service dental insurance plans are those that tend to require payment at the time of service.  Indemnity and Direct Reimbursement plans are examples of Fee for Service insurance. Unless the dental office states otherwise, you will have to pay the dental bill out of pocket then you will file a claim with your insurance company or employer to receive reimbursement.  The benefit of having a Fee for Service dental plan is that you have the freedom of choice when selecting your dentist because you are not limited to a network of dentists. In addition, if you need to see a specialist like an oral surgeon or endodontist, you can make the appointment without the need for a referral from a primary care dentist. The downside to these plans is that they can be more expensive and do not have the controls, such as credentialing and claims review, inherent in quality and cost of care management that a PPO or DHMO typically have.