Dental Insurance Plans... Choose the Right One for Your Situation

Dental insurance plans pay the expenses connected with dental care. They pay a portion of the charges from dentists, orthodontists, hospitals and all other providers of dental care. By doing so, dental insurance protects people from financial hardship caused by unexpected dental expenses.

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. 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. 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 is not highly desirable by a lot of dentists. 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. 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 dental insurance plans had bandages 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". Furthermore, dental insurance plans will generally have a maximum amount that they will pay per year.

If the dentist you use is part of your PPO and sure employer pays the monthly premiums, this might be one of the most attractive dental insurance plans.

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. Although a patient will be seen and treated, the relationship with the dentist is not developed due to lack of time. If you want to be seen by a dentist who takes time with his or her patients, this may not be your optimum dental insurance plan.

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. 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.

Discount dental plans have no limits, no paperwork, and no health restrictions unlike traditional indemnity-based dental insurance. In addition, consumers must pay either a monthly or yearly membership fee in exchange for the ability to get these discounts on dental services. Most of these plans provide a price list or fee schedule with the discounted dental fees and/or costs listed either on their web site or in membership materials to ensure consumers receive the savings 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.

Discount dental plans are configured for groups, families and individuals that wish to save money for their dental care. Participating providers have agreed to accept a discounted fee from plan members as payment-in-full for services performed. In general, plans are active within five business days and sometimes even on the same business day.

You should be extremely careful if you do not have dental insurance, along with a discount dental plan, because you might end up owing a great deal of money to the 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

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
• If you intend to visit a provider, contact them and make sure 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. 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. There is now a state licensed dental discount plan available in California and Arizona.

Return From Dental Insurance Plans... Choose the Right One for Your Situation to Home Page