you are here:DentalPlans.com > Help > Dental Insurance Decisions
Dental Insurance Decisions
At DentalPlans.com, we want to help you make qualified decisions on your dental care options by providing valuable information on dental insurance plans, discount dental plans and more.
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, dental indemnity insurance plans, and discount dental plans – an alternative to the traditional dental insurance plans. Let’s take a closer look at dental insurance plans and discount dental 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.
Discount Dental Plans – An Alternative to Dental Insurance
Discount dental plans, although not a dental insurance product, provide individuals, families, businesses and other groups with an invaluable dental benefit. Discount dental plans are an alternative to dental insurance that provide plan members with discounts on most dental services with a strong emphasis on preventive procedures. Discount dental plan members pay a low membership fee for the year for access to an extensive network of participating dentists and dental specialists that provide deep discounts on dental care at the time of service.
Many individuals and families that do not receive dental insurance from their employers turn to discount dental plans to reduce their out-of-pocket expenses on dental care. Additionally, more businesses are looking toward discount dental plans as an affordable and easy way to provide their employees with a much needed dental benefit.
Since they are not dental insurance plans but discount programs instead, discount dental plans do not have co-payments, deductibles, paperwork hassles or annual limits. Fortunately, many discount dental plans can be coordinated with existing dental insurance coverage. This can prove to be very beneficial for someone who has long waiting periods for pre-existing conditions or has already reached their annual maximum on their dental insurance plan.
In addition, select discount dental plans offer discounts on some dental specialties that are rarely covered by dental insurance, including cosmetic dentistry services like veneers, teeth whitening and more. The low annual membership price and the convenience provided by discount dental plans have made them an affordable and easy-to-use option for people looking to save money on their dental care needs.
Dental Insurance and Discount Dental Plans: A Valued Benefit for Students, Businesses and More
Recent research highlights the importance of dental health and its link to overall health. Studies have shown that affordable dental benefit options are highly coveted by students, employees and more. Despite being a highly desired benefit, an alarming 56% of the U.S. population does not have dental insurance.
The lack of affordable dental care has a significant impact at schools and especially in the workplace. About 164 million hours of work and 51 million hours of school are lost each year due to dental visits, dental related illnesses and other oral health problems, according to Oral Health in America: A Report of the Surgeon General.
Both students and employees consider dental insurance to be an important benefit. For example, a 2006 Graduating Student & Alumni Survey conducted by the National Association of Colleges and Employers showed that graduating students entering the workforce rated dental insurance as a highly valued benefit, behind medical insurance and yearly salary increases. In addition, employees rank dental plans as the third most important benefit, behind health and retirement benefits, according to several recent studies.
Discount Dental Plans: An Alternative to Dental Insurance for Businesses and Groups
According to a 2005 report by the US Census Bureau, 90% of privately insured individuals receive coverage from their own or family member’s employer. Yet 11% of small businesses that offer their employees health benefits right now might not do so next year (Employee Benefit News, August 2006). A spokesman with the Society for Human Resource Management says that dental insurance is at the top of the list of benefits employers are looking to scale back (SmartMoney.com, November 2006).
Many small businesses refrain from offering dental insurance to their employees due to the costs involved. In an attempt to conserve some of the money spent on health benefits, many businesses are moving toward “consumerism” and voluntary dental benefits. Businesses following this trend are shifting the costs of dental insurance plans and discount dental plans from the employer to the employee.
It seems as if traditional dental insurance is losing ground to discount dental plans in some sectors due to this trend toward voluntary dental benefits. Discount dental plans fit the voluntary dental benefit model very well. The discount dental plans offered by DentalPlans.com can be customized to fit the unique needs of a business and its employees.
Employers enjoy the ease offered by money-saving discount dental plans, and employees enjoy choosing the plan that is best for their individual needs. Plus, unlike dental insurance plans, the discount dental plans offered by DentalPlans.com do not have minimum participation policies and they can be used by the employees’ dependents, part-time workers and retirees. More and more businesses are turning to discount dental plans because they save on their bottom line while employees save on their dental care.