Dental insurance is generally sold on a group basis, due to adverse selection. Insurers are reluctant to write individual dental coverage because a person in need of dental work can often postpone treatment until an insurance plan becomes effective, causing the insurer to be liable for larger benefits than it would otherwise expect to pay.

Dental plans base benefits on UCR (usual, customary and reasonable) charges. Charges in excess of this limit are the insured's responsibility and are subject to deductibles and coinsurance. Occasionally, dental insurance is part of a health benefits package with a single deductible called an integrated deductible, applying to both medical and dental coverage. More often, dental coverage is provided through a separate policy with its own deductible.

In addition to deductibles and coinsurance, maximums may also affect the level of benefits payable under a dental plan. Generally, there is a specified maximum dollar amount payable per year and sometimes per family member covered. There may also be a lifetime maximum per individual.

Some dental policies are scheduled (basic) and only cover such things as: •Routine visits to the dentist •Protective fluoride treatments •Diagnostic x-rays •Dental exams and diagnosis •Local anesthetics •Teeth cleanings (usually once every 6 months) •Preventive care

Most dental policies, however, are comprehensive and work much the same way as comprehensive medical expense coverage. Dental procedures covered by most comprehensive policies include: •Restorative •Endodontics •Periodontics •Prosthodontics •Oral pathology •Orthodontics

• Restorative Fillings, crowns and repairing or restoring dental work that has been damaged in some way. • Endodontics Treatment of the pulp (root canals) • Periodontics Treatment of the supporting structures of the teeth • Prosthodontics Artificial replacements and bridge work

• Oral pathology Microscopic analysis of tissue biopsy material for diagnosis of oral diseases including oral cancer • Orthodontics Correction of irregularities of the teeth (braces) Note: Nearly all dental plans pay 100% of the cost of routine cleanings and checkups.

Prepaid Dental Plans In a prepaid dental plan, a corporation, partnership, or other entity provides or arranges for the provision of dental care services to enrollees or subscribers. Prepaid dental plans operate in much the same way as health maintenance organizations. They offer services based on capitation or fixed per member per month payments, where the provider assumes the full risk for the cost of contracted services without regard to the type, value, or frequency of the services provided.