Dental Insurance Plans - The Secrets

Dental insurance plans are insurance designed to pay the costs associated with 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.

Sadly, as stated by the American Dental Association (ADA), less than half of the United States population is covered by any dental insurance plans. Almost all of those people that receive dental insurance sign-up for it through their employer as a secondary part of their health insurance. Depending upon the type of medical coverage you have, it may be a good idea to have a compatible program to eliminate any gaps or overlap within the two plans. 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. This is because it generally means less pay for more work (especially paperwork). It is also important to have adequate coverage for your situation, so you can access the features you need and are not paying for something you will not use. Also, insurance plans have restrictions, such as pre-existing conditions and annual maximum payments.

The most common types of dental insurance plans are either Preferred Provider Organization (PPO) or Dental Health Maintenance Organizations (DHMO). 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. Furthermore, dental insurance plans will generally have a maximum amount that they will pay per year. 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.

A Dental Health Maintenance Organization is another dental insurance plan option, based on the model of medical HMOs. Each person enrolled in these dental insurance plans may choose any dentist available by 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 an HMO set up, dentists have more patients to see and are often compelled to work in an environment where volume matters more than quality. Although a patient will be seen and treated, the relationship with the dentist is not developed due to lack of time. If you want your dentist to take his time with you, you probably should not consider any DHMO dental insurance plans.

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. These types of plans began in the early 1990s, and they offer benefits such as braces, fillings, exams, and routine cleanings in exchange for a discounted fee to its members. A discount of 30 to 35% is what members typically receive.

Discount dental plans have no limits, no paperwork, and no health restrictions unlike traditional indemnity-based dental insurance. 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. For example, your typical discount plan would point you to a dentist who has agreed to participate in the plan that would only charge, say, $650 for a crown instead of the standard rate of $800 to $900. Discount dental plans are designed for individuals, families and groups looking to save money on their dental care needs. Plan members agreed to pay a discounted fee in-full to the participating provider for these discounted dental plans. 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. 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

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.

• 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
• Make sure the provider offers the promised reduction in fees

Understand that dental discount plans are not subject to regulation by state insurance departments. That said, the fact that they are not regulated, doesn't mean that they aren't legitimate... just be cautious. 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.