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Paying For Dental Care – What You Need To Know About Dental Insurance


Today, businesses, families and individuals have a variety of choices to reduce out-of-pocket costs on dental care. These dental insurance options include PPO dental insurance plans , HMO dental insurance plans, and dental indemnity insurance plans. You may also consider dental savings plans – an affordable alternative to the traditional dental insurance plans.


Let’s take a closer look at dental insurance plans and dental savings plans.


PPO Dental Insurance Plans


Dental PPO insurance plans, also known as dental preferred provider organizations or DPPOs, are a popular dental insurance option due to their flexibility in allowing insured members to choose dentists and dental specialists. Typically, PPO dental insurance plans are said to offer better service and have less limitations than HMO dental insurance plans, but the premiums are usually more costly. Businesses often use PPO dental insurance plans to provide their employees with a valuable dental benefit. PPO dental insurance plans are used by individuals and families as well.


Dental preferred provider organizations are managed care organizations with a network of dentists under contract with a dental insurance carrier. This network of dentists provides dental PPO insurance plan members with special rates on dental care. The rates are usually lower if the insured member selects a primary dentist and/or dental specialists from the dental PPO network, but the insured individual still has the freedom to choose a dental care provider outside of the established network.


Despite this flexibility, PPO dental insurance plans have some limitations as well. In addition to the higher premiums usually associated with dental PPOs in relation to other dental insurance plans, they also have tedious claim forms to fill out and insured members usually have to wait to receive reimbursements. Participants insured with a dental PPO insurance plan are responsible for paying their deductible before receiving any reimbursement. In addition, since most dental PPO insurance plans only cover a portion on the dentist’s fee, insured individuals also have to make a co-payment to the dentist. Many people join PPO dental insurance plans because this type of insurance plan gives them more freedom when choosing a dentist and/or dental specialists.


HMO Dental Insurance Plans


Dental HMO insurance plans, also known as dental health maintenance organizations or DHMOs, are usually much cheaper than PPO dental insurance plans and dental indemnity insurance plans. HMO dental insurance plans have networks of dentists under contract with the dental insurance company that offer dental services to insured members at pre-determined rates. HMO dental insurance plans are usually used by businesses to insure their employees, but can be used by individuals and families as well. Individuals who do not receive dental insurance through their employers often turn to HMO dental insurance plans as an option.


One of the main advantages of HMO dental insurance plans is that they usually have lower premiums than the other dental insurance options. Regrettably, HMO dental insurance plans have been known to impose strict restrictions on insured members. For example, the dental HMO will not provide a reimbursement if the insured sees a dentist that is not in their network. People insured with HMO dental insurance plans must select a primary dentist from a pre-approved list. All referrals to dental specialists must be provided by the primary dentist.


One of the key differences between dental HMO insurance and dental PPO insurance is that DPPOs usually allow dentists to spend more time with insured patients. Dentists in dental HMO insurance plans are expected to see a certain number of patients, so some dentists have been known to rush through dental appointments. Additionally, participants in HMO dental insurance plans often complain about tiresome referral and claims procedures. Despite some of the restrictions and limitations associated with this type of dental insurance, HMO dental insurance plans are a feasible option for many people due to their low cost in relation to other dental insurance plans.


Dental Indemnity Insurance Plans


Dental indemnity insurance is usually offered by insurance companies to insure businesses and other groups. Dental indemnity insurance plans are fee-for-service insurance plans that require insured members to pay dentists directly for dental services rendered. People covered by dental indemnity insurance receive compensation from the insurance company by submitting claim forms. Dental indemnity insurance plan members often have to wait a long time to receive their reimbursement from the dental insurance carrier, and are expected to pay the difference if the dentist’s fee is greater than the reimbursement.


Employees and/or group members on a dental indemnity insurance plan can choose dentists, change dentists, and even see a dental specialist without a referral. Despite this freedom, many individuals, families and businesses shy away from dental indemnity insurance plans because of the costly premiums, high annual deductibles, and exhausting claims procedures. Typically, dental indemnity insurance plans are structured to insure groups, so they are usually not good options for individuals and families looking for dental insurance. But if you do need a plan with a higher-than-usual annual cap, some companies do sell indemnity plans to individuals.


Dental Savings Plans – An Alternative to Dental Insurance


Dental savings plans , although not a dental insurance product, provide individuals, families, businesses and other groups with affordable access to dental care. Dental savings plans provide plan members with discounts on most dental services. As an example, the majority of plans you’ll find on dentalplans.com offer savings of 10%-60% at the dentist. The savings depend on the treatment you need, as well as your location (since prices charged by dentists vary by location).


Dental savings plan members pay a low annual membership fee for access to an extensive network of participating dentists and dental specialists that provide discounts on dental care at the time of service.


Many individuals and families that do not receive dental insurance from their employers turn to dental savings plans to reduce their out-of-pocket expenses on dental care.


Additionally, more businesses are looking toward dental savings plans as an affordable and easy way to provide their employees with a much needed dental benefit.


Since they are not dental insurance, dental savings plans do not have co-payments, deductibles, paperwork hassles or annual limits. They are significantly easier for a business or other organization to manage.


Many people find that their needs are best met by having both dental insurance and a dental savings plan. Families with young children may want insurance to cover preventative care for the kids, and a savings plan to make adult care more affordable. Others rely on dental savings plans to bridge the gap between insurance-mandated waiting times for some procedures, or buy a dental savings plan when their dentist informs them that the care they need will cost more than their dental insurance policy’s maximum annual allowance.


In addition, select dental savings plans offer discounts on some dental specialties that are rarely covered by dental insurance, including cosmetic dentistry services like veneers, teeth whitening and more. Those who need or want these treatments often buy a dental savings plan membership to get a discounted rate on the services.


The low annual membership price and the convenience provided by dental savings plans have made them an affordable and easy-to-use option for people looking to save money on their dental care needs.


 

 

 



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Savings plans are NOT insurance and the savings will vary by provider, plan and zip code. These plans are not considered to be qualified health plans under the Affordable Care Act. Please consult with the respective plan detail page for additional plan terms. The discounts are available through participating healthcare providers only. To check that your provider participates, visit our website or call us. Since there is no paperwork or reimbursement, you must pay for the service at the time it’s provided. You will receive the discount off the provider’s usual and customary fees when you pay. We encourage you to check with your participating provider prior to beginning treatment. Special promotions including, but not limited to, additional months free are not available to California residents or on Fully Insured Plans. Note – not all plans and offers available in all markets.

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