Good dental insurance is hard to find. While dental insurance is availiable it is often costly. Many people find dental discount plans to be more cost effective than traditional dental insurance. Being protected by dental insurance and using it wisely are essential safeguards for you and your family.
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Dental Indemnity Plans
This type of plan pays the dentist on a traditional fee-for-service basis. A monthly premium is paid by the patient and/or the employer to an insurance carrier, which directly reimburses the dentist for the services provided. Insurance companies usually pay between 50 percent and 80 percent of the dentist's fee for covered services; the remaining 20 percent to 50 percent is paid by the patient. These plans often have a pre-determined deductible, a dollar amount which varies from plan to plan, that the patient must pay before the insurance carrier will begin paying for care. 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
Dental insurance plans
Dental insurance plans works like most other types of medical coverage. You pay a monthly premium for coverage, and the policy pays for all or most of your related costs. The more expensive the policy, the more extensive the coverage.
While some health plans will cover dental care, many do not. If this applies to you, or if you carry an individual health policy, you may need an individual dental insurance policy to guarantee yourself adequate care.
An good Dental Insurance Plan
should cover all or most of the basic dental procedures, like office visits and cleaning. Care beyond that may or may not be fully covered by a dental insurance policy Generally, as procedures become more expensive, a dental insurance policy will cover fewer and fewer of them.
The popularity of dental insurance has been on the rise over the past few decades. And as dental plans have become more widespread, different coverage options have developed.
Dental insurance premiums continue to skyrocket. So now what do you do? Are there any low cost alternatives that can provide savings on health care for you and your family.
Dental Health Maintenance Organization (DHMO)
A Dental Health Maintenance Organization (DHMO) is a common example of a capitation plan. This type of plan provides comprehensive dental care to enrolled patients through designated provider dentists.The dentist is paid on a per capita (per head) basis rather than for actual treatment provided. Participating dentists receive a fixed monthly fee based on the number of patients assigned to the office. In addition to premiums, patient co-payments may be required for each visit.
Preferred Provider Organization (PPO)
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.
Traditional dental insurance vs managed dental care
The most basic dental insurance plan works on a fee-for-service (also called indemnity) basis. You pay a monthly premium for coverage, and your insurer will pay for all or most of your necessary dental care, no matter where or from whom you choose to receive care.
A newer option is managed dental insurance, which works a lot like managed health care. A managed dental insurance plan covers most of the same service as an indemnity policy would, but premiums are usually lower and freedom of choice in dentists is limited.
Most managed dental insurance plans
work under a PPO (preferred provider organization), which means that policyholders must choose a primary dentist from a list of approved dentists. And to maintain full coverage for all procedures, any specialist you see will have to be approved by this primary dentist.
Basically all individual dental insurance, both fee-for-service and managed care policies, will impose a 6 to 18 month "waiting period
" for most or all procedures, which means services won't be covered until after you've owned your policy for a while. (This is a big reason in favor of buying dental insurance before you know you need it. Like now.)
If you were an employee of a large corporation you might be eligible for their corporate HMO or PPO insurance plan; but those "corporate" type plans are usually unavailable for the self-employed.