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Dental Insurance Plans In
Edward M. Brancheau
Dental insurance plans are insurance designed to pay the costs associated with dental care. Dental care by dentists, orthodontists and hospitals will have a portion of their charges paid by dental insurance. Because of this coverage, unanticipated dental expenses will prevent excessive fiscal hardship.
Sadly, as stated by the American Dental Association (ADA), less than half of the United States population is covered by any dental insurance plans. It seems that people who have dental coverage, purchase it mainly through the companies they work for as part of their health insurance plan. You should consider having a compatible program to fill in the gaps between the two plans depending upon what type of health insurance you have. By doing this, you will receive preventative dental care as well as the advantage of saving money.
However, a lot of doctors find it unpleasant to participate in dental insurance plans. Basically, this means less pay plus more work (especially more paperwork.) It is important to not over-insure nor under-insure so it is important to assess your situation when purchasing adequate coverage. Also, insurance plans have restrictions, such as pre-existing conditions and annual maximum payments.
Dental Health Maintenance Organization (DHMO) and Preferred Provider Organizations are the most frequent sort of dental insurance plans. Both types are considered managed care, and each dental insurance plan has benefits and disadvantages.
Even though dentists provide their services under these plans and have negotiated an what they charge with the insurance companies, all fees are generally not covered. There are deductibles to consider and most of these types of dental insurance plans only pay a percentage of the charges, leaving the patient with a co-pay. There may also be a maximum amount they will pay annually.
Dental insurance plans, where you're dentists is part of the PPO and that your employer pays the monthly premiums are extremely attractive.
A Dental Health Maintenance Organization is another dental insurance plan option, based on the model of medical HMOs. Here, too, the patient is enrolled in a program and can visit any dentist in that program. However, by comparison to a PPO, dentists may not be held to spend as much time with each patient and may end up providing services below cost. In a DHMO, volume matters more than quality, and so dentists are often driven to spend less time with their patients. Although a patient will be seen and treated, the relationship with the dentist is not developed due to lack of time. If you want your dentist to take his time with you, you probably should not consider any DHMO dental insurance plans.
Non-Insurance Dental Plans... An Alternative to Dental Insurance Plans
Usually called Discount Plans or Reduced-Fee-For-Service Plans, these non-insurance programs offer subscribers access to quality dental care at a discounted rate from participating dental providers. These types of plans began in the early 1990s, and they offer benefits such as braces, fillings, exams, and routine cleanings in exchange for a discounted fee to its members. A discount of 30 to 35% is what members typically receive.
Discount dental plans have no limits, no paperwork, and no health restrictions unlike traditional indemnity-based dental insurance. In addition, consumers must pay either a monthly or yearly membership fee in exchange for the ability to get these discounts on dental services. To ensure that customers receive the savings they were promised, most plans will provide a price list or fee schedule for these discounted services.
For example, your typical discount plan would point you to a dentist who has agreed to participate in the plan that would only charge, say, $650 for a crown instead of the standard rate of $800 to $900.
Discount dental plans are configured for groups, families and individuals that wish to save money for their dental care. Dental providers participating in these plans have agreed to accept a discounted fee as payment-in-full for services performed for a plan members. Discount plans activate anywhere from the same day one enrolls to five business days later.
Be careful; if you do not have dental insurance coverage in addition to a discount dental plan, you can be left with a substantial liability for payment to providers. For example, if you have a $2000 dental bill and receive a 25% discount, you would still be liable for $1500. Furthermore, you must be prepared to pay your entire dental bill on the spot, because payment is due when the dental work is completed.
Before Purchasing a Discount Dental Plan
Whether you choose one of the many traditional indemnity-based dental insurance plans or a non-insurance discount dental plan, you should know the answers to everything below before purchasing, because the national Association of dental plans (NADP) has conducted studies that showed that 68% of all consumers pay too much for their dental coverage.
*** Obtain a list of participating dental providers in your ZIP/area code
*** Contact any providers that you plan to see to confirm they still participate in the plan
*** Find out what the provider normally charges for the services you are interested in receiving.
*** Confirm that the provider offers the reduced fees
Be aware that dental-discount plans are not regulated by state insurance departments. That said, the fact that they are not regulated, doesn't mean that they aren't legitimate... just be cautious. You should ask if a licensed insurance company is offering the product and verify with the insurance company if you are unsure if you are purchasing insurance or not. In California and Arizona, there are now state licensed dental discount plans.
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