More than 50% of the people in the United States aren't covered by any of dental insurance plans according to the American Dental Association (ADA). Those who do have dental coverage often get it through their employer as part of their health insurance plan. You should consider having a compatible program to fill in the gaps between the two plans depending upon what type of health insurance you have. By doing this, you will receive preventative dental care as well as the advantage of saving money.
However, a lot of doctors find it unpleasant to participate in dental insurance plans. This is because it generally means less pay for more work (especially paperwork). 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 types are considered managed care, and each dental insurance plan has benefits and disadvantages.
Dentists participating in the PPO plans have negotiated their fees with the administering company, and provide their services under the plan, but this usually does not cover all fees. The difference between what the dentist charges and what the dental insurance plans cover is what is referred to as the "co-pay". There may also be a maximum amount they will pay annually.
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, 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. In a DHMO, volume matters more than quality, and so dentists are often driven to spend less time with their patients. Although a patient will be seen and treated, the relationship with the dentist is not developed due to lack of time. A DHMO is probably not one of the dental insurance plans that you want to choose if you want your dentist to spend quality time with you.
Non-Insurance Dental Plans... An Alternative to Dental Insurance Plans
In these types of plans, commonly called Reduced-Fee-For-Service or Discount Plans, participating dental providers provide care at a discounted rate to the plan subscribers. 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. These dental plans will provide a price list on either their website or in membership materials so that consumers know that they are receiving the savings that 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. Dental providers participating in these plans have agreed to accept a discounted fee as payment-in-full for services performed for a plan members. 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 plans, 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. 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
You should know the answers to all of the questions below before you purchase any type of dental coverage, whether you are choosing a non-insurance discount plan or are one of the many traditional indemnity-based dental insurance plans.
*** Request a list of participating providers in your zip or area code
*** Contact any providers that you plan to see to confirm they still participate in the plan
*** Find out what the provider normally charges for the services you are interested in receiving.
*** Confirm that the provider offers the reduced fees
Be aware that dental-discount plans are not regulated by state insurance departments. However, just because they are not regulated by the state does not mean that they aren't legitimate but you should remain cautious when signing up in one. You should ask if a licensed insurance company is offering the product and verify with the insurance company if you are unsure if you are purchasing insurance or not. In California and Arizona, there are now state licensed dental discount plans.
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