CONSULATE
Consulate Dental Plan, Understanding Reimbursement Levels.
Many dental insurance plans (such as PPO and Indemnity) offer three classes or categories of coverages (Preventive, Basic, and Majors). Each class provides specific types of treatment and typically covers those services at a certain percentage. Reimbursement levels can vary from plan to plan, so once again reading each plans benefits, limitations, and exclusions is very important in order to buy the plan that best fits your dental needs.
However here is an example of how a dental insurance plan may brake down the three levels
* Class 1 (Preventives): Preventive services normally include diagnostic, office visits, X-rays and cleanings. Class 1 procedures are typically covered at the highest percentage such as 80-100 percent up to the plans maximum allowance.
* Class 2 (Basics): Basic services normally include fillings, Space maintainers and re-cementation of crowns. Class 2 procedures typically covered at a little less such as 60-80 percent up to the plans maximum allowance.
* Class 3 (Majors): Major services normally include root canals, treatment of gum disease, oral surgery and crown, bridges, partial and dentures. Class 3 procedures are usually reimbursed at the lowest percentage, such as 40-50 percent up to the plan maximum allowance.
* Class 4 (Orthodontic): Some plans many have a fourth class which is normally for any orthodontic services if the plan provides benefits for braces.
Many plans also have waiting periods for class 1 and 2 in addition to deductibles. Keep in mind the above is only an example and each dental insurance plan can vary in both coverages and reimbursement levels.