What is direct reimbursement for dental care?
Usually not. Dental services are often divided into different coverage levels. Level I services include semiannual examinations, semiannual cleaning, x-rays and diagnosis. Most plans cover at least preventive and diagnostic care. Level II (basic services) includes simple restoration (fillings), crowns and jackets, repair of crowns, extractions and endodontic (root canals and internal pulp treatment). Level III (major services) includes dentures, bridges and replacement of bridges and dentures. In order to emphasize prevention, many plans cover the Level I services at higher reimbursement levels than Level II or III services.
Direct reimbursement is a noninsured dental program in which an employer agrees to pay for a specified percentage or amount of receipted dental expenses. It has been used by smaller employers as a way of avoiding both the costs associated with an insured plan and the administrative complexity that often accompanies insurance company programs. And, since dental expenses are more predictable than medical expenses — seldom involving emergencies or catastrophic expenses — the risk to employers is considerably smaller.
