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Dental Insurance Plans - The Secrets

By Expert Author: Edward M Brancheau
Word Count: 935 words | Views: 501 view(s)
Dental insurance plans are designed to cover the costs of dental care. Dental care by dentists, orthodontists and hospitals will have a portion of their charges paid by dental insurance. By doing so, dental insurance protects people from financial hardship caused by unexpected dental expenses.

More than 50% of the people in the United States aren't covered by any of dental insurance plans according to the American Dental Association (ADA). Those who do have dental coverage often get it through their employer 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. The main benefit of doing this is that you will probably save money and, at the same time, be able to take advantage of receiving preventive dental care.

That said, dental insurance plans are not highly desirable by a lot of dentists. Basically, this means less pay plus more work (especially more paperwork.) So that you can receive the benefits that you need while not paying for features that you will not use, it is important to assess your situation and purchase adequate coverage. Restrictions such as pre-existing conditions are and just about all dental insurance plans so it is important to keep this in mind.

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.

All fees are generally not covered because even though dentists provide their services for these plans and have agreed upon amount that they will charge the insurance companies, there are still a few fees left unpaid. 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.

Dental insurance plans based on medical HMOs are called DHMOs, and they are another option. The enrolled patient can go to any dentist they choose 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. Due to lack of time, even though a patient will eventually be seen and treated, there is no true relationship between the dentist and the patient. A DHMO is probably not one of the dental insurance plans that you want to choose if you want your dentist to spend quality time with you.

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. Beginning in the early 1990s, dental programs such as these off her members a variety of dental services such as exams, fillings, braces and routine cleanings at a reduced rate. A discount of 30 to 35% is what members typically receive.

Unlike traditional indemnity-based dental insurance, discount dental plans have no annual limits, no health restrictions and no paperwork. In order to receive these discounts on dental services, members pay a monthly or yearly fee. To ensure that customers receive the savings they were promised, most plans will provide a price list or fee schedule for these discounted services.

A typical discount plan, for example, would direct you to a dentist that has agreed to charge a discounted rate, say $700 for a crown instead of $800.

Individuals, groups and families that want to save money are the people that these discount dental plans are geared towards. Participating providers have agreed to accept a discounted fee from plan members as payment-in-full for services performed. 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. In addition, because payment due at the time of service (i.e. when your dental work is completed), be prepared to pay your dental bill in full before leaving the dental office.

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.

*** Request a list of participating providers in your zip or area code

*** Contact each provider that you intend to visit to make sure they still participate in the plan

*** Ask the provider the normal fees are for anything you are interested in having done

*** Confirm that the provider offers the reduced fees

Be aware that dental-discount plans are not regulated by state insurance departments. That doesn't mean these plans aren't legitimate, but you should take precautions when buying one. If you are uncertain whether you are purchasing insurance or not, simply ask if a licensed insurance company is offering the plan and verify this with the insurance company. California and Arizona, both now offer state licensed dental discount plans.
Edward M Brancheau

About the Author:

Ed Brancheau, aka The Insurance Egghead, guides businesses, families and individuals toward finding dental insurance plans. His website, The Insurance Egghead, has pages and pages of free guides, articles and advice about every type of insurance: health, dental, vision, accident and life.

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