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Understanding the Various Types of
Dental Insurance and Dental Discount Plans we offer...
Finding the right value in dental
insurance vs dental plans is an important step in purchasing dental
coverage for you and your family. Both types of dental plans have
advantages and disadvantages and one size does not fit everyone.
Keeping this in mind is an important rule when you shop for the dental
plan that best fits your needs. We sell both individual and family
dental insurance and dental discount plans throughout all 50 states.
Here are some brief examples that may help you decide.
Dental Discount
This type of dental plan is not insurance. The managing organizations have
negotiated with local dental offices to establish a set price for a
particular dental procedure and offer deep discounts (some up to 70%)
off the regular ADA pricing code. This plan has several advantages over
traditional dental insurance plans, namely, there are no exclusions for
pre-existing conditions. This allows a patient to receive immediate
coverage for work without meeting any waiting period requirements.
Indemnity - Dental Insurance
This is the plan where
you choose your own dentist. The dental insurance plan pays the dental office (dentist) on a
traditional fee-for-service basis. A monthly premium is paid by the
client and/or the employer to an insurance company, which then
reimburses the dental office (dentist) for the services rendered. An
insurance company usually pays between 50% - 80% of the dental office
(dentist) fees for a covered procedures; the remaining 20% - 50% is
paid by the client. These plans often have a pre-determined or set
deductible amount which varies from plan to plan. Indemnity plans also
can limit the amount of services covered within a given year and pay the
dentist based on a variety of fee schedules.
Some typical features of these plans:
-
High deductibles before coverage
begins (well-designed plans don't apply the deductible to preventive
services)
-
Probationary periods on certain
procedures that last up to a year
-
Annual dollar limit on benefits
-
Chose your own dentist
-
Your average monthly cost: $15 to $25
-
Companies selling these plans are
regulated by state insurance departments.
Dental HMOs
These insurance plans, also known as "capitation plans," operate
like their medical HMO cousins. This
type of dental plan provides a comprehensive dental care to enrolled
patients through designated provider office (dentist). A Dental Health
Maintenance Organization (DHMO) is a common example of a capitation
plan. The dentist is paid on a per capita (per person) basis rather than
for actual treatment provided. Participating dentists receive a fixes
monthly fee based on the number of patients assigned to the office. In
addition to premiums, client co-payments may be required for each visit. Some
typical features of these plans:
-
Monthly premiums (some
require you to prepay a year's worth)
-
Co-payments for office
visits
-
Free preventive or routine
care
-
You must select from an
approved network of dentists
-
May have an initial
enrollment fee
-
Annual dollar cap
-
Your average monthly cost:
$5 to $15
-
Companies selling these
plans are regulated by state insurance departments.
Preferred Provider Organizations
Another true insurance plan, a
Preferred provider organizations ( PPO) falls somewhere between an indemnity
plan and a dental HMO. This plan allows a particular group of patients to receive dental care
from a defined panel of dentists. The participating dentist agrees to
charge less than usual fees to this specific patient base, providing
savings for the plan purchaser. If the patient chooses to see a dentist
who is not designated as a "preferred provider," that patient
may be required to pay a greater share of the fee-for-service. A group of dentists agrees to provide services at a
deeply discounted rate, giving you substantial savings — as long as you
stay in their network. Unlike the more restrictive DHMO, though, you can
go out of network and still receive some benefits. Some typical features
of these plans:
-
Monthly premiums
-
Annual dollar cap
-
You must stay within the
approved network of dentists or pay higher deductibles and co-payments
-
Your average monthly cost:
$20-25
-
Companies selling these
plans are regulated by state insurance departments.
Direct Reimbursement Plans
A dental care plan now coming into vogue is the direct reimbursement plan.
This is a self-funded benefit plan — not insurance — in which an
employer pays for dental care with its own funds, rather than paying
premiums to an insurance company or third-party administrator. You, the
patient, pay the full amount directly to the dentist, then get a receipt
detailing services rendered and the cost, which you show to your employer.
The employer reimburses you for part or all of the dental costs, depending
on your specific benefits.
Your company might reimburse 100 percent of your first $100 of dental
expenses and then 80 percent of the next $500, and 50 percent of the next
$2,000, with a total annual maximum benefit of $1,500. Or it might
reimburse only 50 percent of your first $1,000, resulting in a $500 yearly
cap.
Some typical features of a direct reimbursement plan:
-
Neither you nor your
employer pay monthly premiums
-
Freedom to choose any
dentist
-
Typical employer cost:
depends on the number of employees and
-
benefit caps
-
Benefits usually capped at
$500 to $2,000 annually.
Dental Insurance Disclosure
The dental insurance programs listed are
based upon the zip code you entered and their availability. If we are
unable to offer a dental insurance plan, we will provide a dental
discount plan, if available, and clearly state it. Please be sure to
contact the plan dental office to confirm they are accepting new
patients and they are accepting the dental plan you have selected. If
you have any dental plan questions please feel free to
contact our office during
regular business hours. You will find our licensed insurance agents ready to
assist you.
Our dental web site is
very clear if you are selecting a dental insurance plan or a dental
discount plan. We understand that there are many dental plan web sites
popping-up all over the internet, claiming to offer "dental insurance"
when in fact they do not and are not licensed to offer a dental
insurance plan. If you find a site that says they offer dental
insurance, they are "required" to show their insurance license
information on the web site, as noted at the bottom of this page. If
they don't, then report them to your local state department of
insurance. If you
find a dental web site stating they offer "dental insurance" and in
fact they don't, then take the opportunity to report that site to the
search engine you found them on.
Our
entire staff is licensed to offer, sell and service dental insurance.
Always ask to speak with a licensed insurance agent. Ask them if they
are licensed. Full disclosure is our guarantee...
These other dental sites may help you
find the right dental plan or dental insurance coverage plans.
Dental4less.com,
USAmericanDental.com,
MultiFlexDental.com,
DentalBenefit.com,
InsComp.net,
BabyDental.com,
BestDentalPlans.com,
BuyDentalOnline.com,
CostLessDental.com,
DentalCareClub.com,
DentalCareOnly.com,
DentalFlex.com,
DentalHighway.com,
DentalofAmerica.com,
DentalOpinions.com,
DentalOutlets.com,
DentalPlanCentral.com,
DentalPlanCompany.com,
DentalPlanDirect.com,
DentalPriceLine.com,
DrDental.com,
DrDentalPlan.com,
ezDentalPlan.com,
MultiFlexDental.com,
OnlineDentalHelp.com,
OnlineDentalInsurance.com, and
OnlineInsuranceNetwork.com.
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DENTAL
INSURANCE HELP AND INFORMATION
Cleaning Your Teeth:
Replace your toothbrush
every three or four months or sooner if the bristles become
frayed. A worn toothbrush will not do a good job of
cleaning your teeth.
Children’s toothbrushes often need replacing more frequently
than adults because they can wear out sooner...
Dental Sealants:
Dental
sealants act as a
barrier, protecting the teeth against decay-causing bacteria.
The sealants are usually applied to the chewing surfaces of
the back teeth (premolars and molars) where decay occurs most
often...
Dentures:
If you’ve lost all of your
natural teeth, whether from periodontal disease, tooth decay
or injury, complete
dentures can replace your
missing teeth and your smile. Replacing missing teeth will
benefit your appearance and your health...
Different
Dental Insurance Plans for Different Needs:
Consumers can choose from
an assortment of
dental benefits plans
that accommodate a variety of needs and expectations. The
following factors differentiate one plan from another...
Dental
Health:
Based on information gathered
during the 2001 American Dental Association (ADA) annual
session,
dentists report that oral
bacteria, in some studies, have been associated with heart
disease, stroke, diabetes and the birth of pre-term, low-
birth- weight babies...
Wisdom
Teeth:
Wisdom teeth are a
valuable asset to the mouth when they are healthy and properly
positioned. Often, however, problems develop that require
their removal. When the jaw isn't large enough to accommodate
wisdom teeth...
Tooth Decay:
Although
tooth decay
has declined among young children as a group, it can still be
a problem for individual children, and even teens and
adults...
Making
Informed Choices: The
law mandates that consumers with dental coverage receive a
fully detailed patient
information handbook
-- a
Description of Benefits -- that clearly outlines coverage,
limitations and exclusions...
Choosing
a Dentist: Dental benefits plans can be categorized by the
options offered for
selecting a dentist. Some
plans allow you the freedom to choose your own dentist...
Paying
the Dentist:
When choosing a benefits plan, it
is important to know who pays what to whom. Dental plans can
be categorized into three types based on the
compensation and
treatment provided...
All
Dental Plans have their Limitations:
Today's health insurance, including your
dental plan, is designed to help you get the care you need at
a
reasonable cost. Because
each person's oral health is different, costs can vary widely.
To control dental treatment costs...
Annual
Benefits: To help contain costs, your plan may limit your
benefits by number of procedures and/or dollar amount in a
given year. In most cases, particularly if you've been getting
regular
preventive care, these
limitations allow for adequate coverage...
Getting
the Most out of Your Dental Plan:
To take full advantage of your
dental benefits plan, visit the
dentist regularly and get
the preventive care that will keep your mouth healthy...
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