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Dental Insurance Plans Secrets Revealed

Dental insurance plans pay the expenses connected with dental care. Dental insurance pays a portion of the bills from dentists, hospitals, and other providers of dental services. 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. 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.

However, a lot of doctors find it unpleasant to participate in dental insurance plans. For one, it means more work for them (and especially more paperwork), and less pay. It is also important to have adequate coverage for your situation, so you can access the features you need and are not paying for something you will not use. 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.

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. Additionally, there may be an annual maximum amount that the dental insurance plans will pay.

If your employer is paying the monthly premiums for the dental insurance plan and the dentist you use is part of the PPO, this might be an attractive option.

A Dental Health Maintenance Organization is another dental insurance plan option, based on the model of medical HMOs. Each person enrolled in these dental insurance plans may choose any dentist available by 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. In an HMO set up, dentists have more patients to see and are often compelled to work in an environment where volume matters more than quality. Due to lack of time, even though a patient will eventually be seen and treated, there is no true relationship between the dentist and the patient. If you want your dentist to take his time with you, you probably should not consider any DHMO dental insurance plans.

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. Having been around since the early 1990s, these dental benefits programs offer their members discounts on a variety of dental services, such as fillings, braces, exams and routine cleanings in exchange for a fee. Members typically receive a discount of 30%-35% off 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.

Individuals, groups and families that want to save money are the people that these discount dental plans are geared towards. Dental providers participating in these plans have agreed to accept a discounted fee as payment-in-full for services performed for a plan members. Discount plans activate anywhere from the same day one enrolls to five business days later.

Even if you have a discount dental plan, if you are not covered by any dental insurance plans, you might be liable to dental providers for a substantial amount of money. For example, you would still be liable for $1500 if you receive a 25% discount on a $2000 dental bill. In addition, because payment due at the time of service (i.e. when your dental work is completed), be prepared to pay your dental bill in full before leaving the dental office.

Before Purchasing a Discount Dental Plan

Because studies done by the National Association of Dental Plans (NADP) show that 68% of all buyers pay too much for their dental coverage, you should know the answers to these questions before purchasing any type of dental coverage, whether be one of the traditional indemnity based dental insurance plans or a non-insurance discount plan.

*** Ask for a list of participating providers in your area/zip 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.

*** Make sure the provider offers the promised reduction in fees

Understand that dental discount plans are not subject to regulation 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. 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.

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

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