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. 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. Those who do have dental coverage often get it through their employer 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. That may save money while allowing you to take advantage of receiving necessary preventive care.

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. So that you can receive the benefits that you need while not paying for features that you will not use, it is important to assess your situation and purchase adequate coverage. Restrictions such as pre-existing conditions are and just about all dental insurance plans so it is important to keep this in mind.

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.

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. 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.

Dental insurance plans, where you're dentists is part of the PPO and that your employer pays the monthly premiums are extremely attractive.

Based on medical HMOs, DHMOs offer other dental insurance plans. The enrolled patient can go to any dentist they choose in 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. Working in an HMO setting, the dentist has many more people to see and is compelled to function in an environment where volume matters. A true relationship between the dentist and the patient does not really exist even though the patient will be treated, because there is an extreme 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. 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. Members can expect to receive a discount around 30 to 35% off the retail prices.

Contrast to traditional indemnity-based and dental insurance, these discounted dental plans have no annual limits, no health restrictions and essentially no paperwork. 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.

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. 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. Furthermore, you must be prepared to pay your entire dental bill on the spot, because payment is due when the dental work is completed.

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.

*** Obtain a list of participating dental providers in your ZIP/area code

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

*** Ask the provider the normal fees are for anything you are interested in having done

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

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