• Dental Insurance
  • Discount Plans
  • Indemnity Plans
  • Dental HMO's
  • Dental PPO's

Dental Insurance

Finding the right value in dental insurance vs dental plans is an important step in purchasing dental coverage for you and your family. Both types of dental plans have advantages and disadvantages and one size does not fit everyone. Keeping this in mind is an important rule when you shop for the dental plan that best fits your needs. We sell both individual and family dental insurance and dental discount plans throughout all 50 states. Here are some brief examples that may help you decide.

Dental Discount Plans

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 up to 70%) off the regular ADA pricing code. This plan has several advantages over traditional dental insurance plans, namely, there are no exclusions for pre-existing conditions. This allows a patient to receive immediate coverage for work without meeting any waiting period requirements.

Indemnity Plans

This is the plan where you choose your own dentist. The dental insurance 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.

Dental HMO's

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.

Dental PPO's

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.

 
 
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