PSI Ohio Insurance Practice Exam

In dental insurance, what does comprehensive coverage typically imply?

1. Covers all dental procedures without limits

2. Pays a percentage of usual and customary charges

3. Includes both preventive and major procedures

4. Offers higher coverage limits than basic plans

The correct answer is: Pays a percentage of usual and customary charges

In dental insurance, comprehensive coverage typically implies that the plan provides broader benefits compared to basic coverage options. One key aspect of comprehensive coverage is that it often pays a percentage of what is considered usual and customary charges for various dental treatments. This means that instead of covering the full cost, it reimburses the insured a portion of the charges based on what is commonly charged in the local area for similar services. This structure encourages policyholders to utilize dental services as needed while also maintaining a balance between cost and benefit for both the insurer and the insured. Comprehensive plans usually include coverage not only for preventive services like cleanings and exams but also for more significant procedures such as fillings, crowns, and even orthodontics, providing a holistic approach to dental health. In contrast to this, other options may imply complete coverage without limits, or higher coverage limits than basic plans, which does not accurately represent the essence of comprehensive plans that prioritize a reasonable percentage of reimbursement. Thus, the option that emphasizes the payment of a percentage of usual and customary charges accurately reflects the nature of comprehensive dental insurance coverage.