What are Out-Of-Pocket (OOP) Expenses?

Out-of-pocket expenses, frequently referred to as OOP expenses, are the costs that you—not your dental insurance—pay for dental services.

You can lower your OOP expenses by paying close attention to your dental plan’s benefits and limitations, using network dental providers and taking advantage of preventive/diagnostic dentist visits.

Examples:

• Deductibles, coinsurance, expenses beyond your plan’s annual maximum and the costs of non-covered services are considered OOP expenses.

FAQs

• Are premiums considered OOP expenses? No. OOP expenses refer to your costs of the dental services you receive.
• How can I minimize my OOP expenses? You can lower your OOP expenses by
  • practicing good oral hygiene to reduce the risk of dental diseases;
  • taking advantage of regular preventive/diagnostic dental visits, which are typically covered 100% by the insurance company and
  • obtaining dental care from network dentists.
• Are OOP expenses the same as co-insurance? Co-insurance is part of your OOP expenses. You may have additional OOP expenses, such as a deductible.

Example of Out-of-Pocket Expenses

This pie chart illustrates the OOP expenses you would pay for a covered dental procedure.

Let’s assume you have not yet met your deductible and your plan covers 80% of the cost. Your OOP expenses comprise your deductible and the 20% co-insurance.

Delta Dental of Arkansas Offers Dental and Vision Insurance for Individuals and Groups

Are you interested in our dental coverage plans so you don’t have to pay the full dentist bill yourself? Check out our insurance options for individuals and families, and small, mid-size and large groups.

And while you’re browsing, take a look at our vision insurance, too.

More Dental Insurance Terms Explained

1. What is a premium?
2. What is a waiting period?
3. What is a network dentist?
4. What is a benefit period?
5. What are preventive/diagnostic, basic and major dental procedures?
6. What is a deductible?
7. What is a copay?
8. What is co-insurance?
9. What is an annual maximum?
10. What is a claim?
11. What is an explanation of benefits (EOB)?
12. What is a pre-determination of benefits?
13. What are out-of-pocket expenses?

Back to Dental Insurance Terms Explained: A Quick Guide

Are there additional dental insurance terms you’d like us to add to this series?

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