Dental Plans & Insurance
Oral/dental health plays one of the most important roles in assuring a person’s overall health and confidence to face the day. A broken/dislocated tooth and swollen gums often lead to compromises in human performance, both psychologically and socially. Dental health problems can be easily fixed in today’s modern technology. The once dangerous procedures can be done today in a fraction of the minute. Moreover, the dental health products and dental health insurance people have today are very beneficial to cutting costs and preventing dental maladies from worsening.
Before, there were no such things as dental health products other than toothpaste and dental floss; now, there are a lot of dental health products in the market available for commercial use – at very affordable prices.
The most important factor of avoiding large dental costs is thru applying (or through your employer’s application) to a reputable and renowned dental insurance company. We’re sure you’ve heard about Blue Cross, Denta Dental and a Metlife – these are just some of the names that have stricken a commanding presence in the field of dental insurance. The main purpose of these dental insurance companies is to reduce the cost (or in some cases, absorb the entire cost) of dental procedures.
These dental insurance companies play in relieving dental patients the worries of having to pay a hefty sum for dental procedures; depending on your case, the insurance coverage will really help in decreasing the costs incurred.
By signing up for our newsletter below, you can get free information on dental health plans that will suit your budget and needs. The best part is, you can the nearest office in your area. With us backing you up, you’re teeth are definitely in safe hands.
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More Information about Dental Plans & Insurance
How exactly will dental insurance coverage help me?
Before proceeding to the dentist, it is important to know about dental insurance plans and their coverage for the dental procedure that you are about to go through. Most dentists accept insurance coverage for the patients’ benefit, but it is very important to ask the dentist first before going through the procedure itself.
It is imperative that one should ask both the dental insurance provider and the dentist himself if they both accept each other’s terms. If one side agrees and the other disagrees, there might be discrepancies, leading to the forfeit of the dental insurance coverage.
What if the dental office is on my insurance plan’s “out-of-network” list?
An out of network list means big trouble. If you’re looking for say, a dentist who can perform a major dental procedure on you, it is important that you first consult your insurance provider and ask for dentists who are in their “network”. An out-of-network dentist means that his practice has not yet been added to the list of approved dental offices by your insurance provider.
An out of network dentist may mean two crucial problems: one is that you might not find the insurance coverage very pleasing, as it might reimburse or cover only a fraction the actual procedural costs; the worst case scenario is that if it doesn’t cover any expense, leaving you to pay the entire bill all by yourself.
What is DMO or a DHMO?
DMO stands for Dental Maintenance Organization. This body provides preventive dental services that will be covered by your insurance provider and giving assurance that 100% of the costs will be subtracted from your co-payment. Newly-established dental clinics are mostly the ones who provide the preventive dental services. Though regarded by some as very helpful, the practice these dental experts give are only limited to preventive and general dentistry, in most cases.
What are the discrete differences between a DMO and an indemnity dental plan?
A Dental Maintenance Organization (as mentioned above) limits itself to the services of the network of dentists providing it, and in most cases the dentists in this network are new in their practice; hence, the 100% coverage on the procedure. On the other hand, an indemnity dental plan gives the patient the liberty to choose a dentist of his/her choice, mostly choosing services from veteran dentists. One difference between a DMO and an indemnity dental plan is that in the latter, the patients are required to pass claim forms with the co-insurance and deductible amount, both of which are subject to approval. Programs related to these plans are listed below:
Direct Reimbursement Programs:
This plan offer offers a full or partial reimbursement on the costs incurred by the patient on the procedure. Certain limitations may apply.
“Usual, Customary and Reasonable” (UCR) programs:
This plan gives the patient the liberty to choose the dentist of his/her own choice. Though this may sound appealing, certain strings are attached: this plan pays only a proportion of the dentist’s payments or the plan administrator’s fee limit, whichever is lower. The three parties involved should all agree on this plan. The lack of government regulations on this program makes it easy for a few dentists to overcharge.
Preferred Provider Organization (PPO):
This plan offers to cover an reasonable amount of fees incurred by the patient. The term “preferred” comes from the notion that a newly-practicing dentist offers himself to be the preferred dentist of the patient. This works mutually for all the parties, because: 1.) It lets the dentist obtain a patient (which in most cases, are hard for newly-formed dental clinics); 2.) It is good for the patient since newly-practicing dentists only charge low fees; 3.) The insurance provider will pay lesser bills.