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Dental Insurance
and Dental Plans types we offer:
Dental Insurance Disclosure
All of these types of dental
plans listed below may not be available in your state. 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.
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...
Indemnity Plans
This type of
dental 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:
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High
deductibles before coverage begins (well-designed plans don't
apply the deductible to preventive services)
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Probationary
periods on certain procedures that last up to a year
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Annual dollar
limit on benefits
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Chose your own
dentist
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Your average
monthly cost: $15 to $25
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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:
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Monthly
premiums (some require you to prepay a year's worth)
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Co-payments for
office visits
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Free preventive
or routine care
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You must select
from an approved network of dentists
-
May have an
initial enrollment fee
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Annual dollar
cap
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Your average
monthly cost: $5 to $15
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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:
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Monthly
premiums
-
Annual dollar
cap
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You must stay
within the approved network of dentists or pay higher
deductibles and co-payments
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Your average
monthly cost: $20-25
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Companies
selling these plans are regulated by state insurance
departments.
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
from 20-60%) off the regular ADA pricing code. This plan has
several advantages over traditional dental insurance plans. This
allows a patient to receive immediate service for work without any
waiting requirements and no limits on use.
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:
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Neither you nor
your employer pay monthly premiums
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Freedom to
choose any dentist
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Typical
employer cost: depends on the number of employees and
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benefit caps
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Benefits
usually capped at $500 to $2,000 annually.
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DentalBenefit.com
is a benefit