Articles & News On Insurance

Dental Insurance Plans... How to Choose the Right One

Dental insurance plans are insurance designed to pay the costs associated with dental care. They pay a portion of the charges from dentists, orthodontists, hospitals and all other providers of dental care. This helps people protect themselves from extreme financial hardship due to unanticipated expenses for dental care.

The American Dental Association states that more than half of the population in the United States are not covered by any dental insurance plan. 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.

Not all dentists are pleased about participating in a dental insurance plans. For one, it means more work for them (and especially more paperwork), and less pay. It is important to not over-insure nor under-insure so it is important to assess your situation when purchasing adequate coverage. Furthermore, you should keep in mind that all insurance plans have restrictions such as annual maximum payments and pre-existing conditions.

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. The difference between what the dentist charges and what the dental insurance plans cover is what is referred to as the "co-pay". Additionally, there may be an annual maximum amount that the dental insurance plans will pay.

If your employer is paying the monthly premiums for the dental insurance plan and the dentist you use is part of the PPO, this might be an attractive option.

Based on medical HMOs, DHMOs offer other dental insurance plans. Here, too, the patient is enrolled in a program and can visit any dentist in that program. However, dentists may end up having to provide services at 'below cost' rates, and not be able to spend as much time with each person as a PPO could offer. Working in an HMO setting, the dentist has many more people to see and is compelled to function in an environment where volume matters. 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

These non-insurance programs, commonly referred to as Discount Plans or Reduced-Fee-For-Service Plans, offer access to dental care at a lower rate from participating dental providers. Having been around since the early 1990s, these dental benefits programs offer their members discounts on a variety of dental services, such as fillings, braces, exams and routine cleanings in exchange for a fee. Members can expect to receive a discount around 30 to 35% off the retail prices.

Discount dental plans have no limits, no paperwork, and no health restrictions unlike traditional indemnity-based dental insurance. In exchange, members pay either a monthly or yearly membership fee. These dental plans will provide a price list on either their website or in membership materials so that consumers know that they are receiving the savings that they were promised.

In order to save you money, this discount plan would give you a list of dentists that have agreed to charge a discounted rate, say $700 for a crown, versus the normal $850.

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, a 25% discount applied to a $2000 dental bill would still leave a person with a $1500 liability. When dental work is completed, payment is due, so it is very important that you be prepared to pay your entire bill before leaving.

Before Purchasing a Discount Dental Plan

You should know the answers to all of the questions below before you purchase any type of dental coverage, whether you are choosing a non-insurance discount plan or are one of the many traditional indemnity-based dental insurance plans.

*** Ask for a list of participating providers in your area/zip code

*** Contact any providers that you plan to see to confirm they still participate in the plan

*** If you are interested in having a procedure done, ask the provider with the normal fee is

*** Verify that reduced rates are offered by the provider

Finally, be advised that state insurance departments do not regulate dental discount plans. However, just because they are not regulated by the state does not mean that they aren't legitimate but you should remain cautious when signing up in one. If you are not sure whether the product is insurance, you should ask whether a licensed insurance carrier is offering the product and verify this information with the insurance company. There is now a state licensed dental discount plan available in California and Arizona.

Ed Brancheau, The Insurance Egghead (http://www.insurance-egghead.com), assists individuals, families and businesses find dental insurance plans (http://www.insurance-egghead.com/dental-insurance-plans.html). Visit his website, The Insurance Egghead, for tons of free advice and guides about health, dental, vision, accident and life insurance.

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