Dental Insurance Plans

by avengerki » Tue Apr 29, 2008 08:47 pm

What are the dental insurance plans to go for?

Dental insurance plans are primarily of 2 types:
  • 1. Indemnity plans
    2. Managed Care Plans

Indemnity/fee-for-service plans
This plan allows the insured to pick a dental care professional of his choice from the existing network of the insurance company. The claim may be then forwarded to the insurance company. You will be reimbursed for part or all of your dental care as mentioned in the policy. This plan may be favorable for those who seek more options in dental care.

Managed Care plans

Managed care is classified into:
  • Dental Preferred Provider Organization (PPO) Insurance Plan: The PPO plan allows individuals to avail treatment and discounts from dentists who are a part of a network. This insurance plan allows you to visit dentists outside the network too, but in this case it may cost you more than what your plan covers.

  • Dental Health Maintenance Organization (DHMO) Insurance Plans: There is a group of dentists who are part of the network formed by the DHMO. Only individuals covered under family DHMO or individual DHMO can avail the services. If you are not a part of the same plan then you are not entitled to any coverage.

  • Dental Point of Service (POS) Insurance Plans: In this plan there are 2 options. You can either visit a dentist who is part of the insurance plan network or you may visit a dentist outside the insurance plan network. If you choose to visit a dentist who is outside the network, you will end up paying more.

Dental plans too, like so many other policies can be opted either under individual plans and group plans.

Individual Dental Insurance:

Individual dental insurance is a very popular form of coverage and is sold directly by the insurance company to its client. However, this policy is not easy to find. Some employers may provide such coverage. Insurance companies often sell these plans as “referral plans” and sometimes also as “buyers' clubs”.

Group Dental Insurance
It is recommended by experts that you should get a group dental insurance if you can. It costs less than an individual dental insurance policy and also provides the most comprehensive care. There are several group dental plans where you may also declare dependents in which case you may be allowed to insure your entire family. This group dental plan helps in reducing the cost of dental care to a great extent.

What are the benefits of a group dental insurance policy?
In a group dental insurance policy, the insurance provider offers coverage for an entire group instead of an individual alone. The benefits include:

  • Insurance providers who offer group insurance mostly charge lower monthly or yearly premiums. The entire group in this insurance policy helps keep the dental insurance costs down.

  • Individual plans and many discount plans cover preventive and diagnostic care. But group dental insurance plans allow the insured to cover their family members, major dental work, orthodontic treatments and children.

  • Group dental insurance plans often offer their members a wide range of services. Special discounts on family plans, special offers on individual plans for single employees, and special plans for employees who are in need of extra care. Many insurance providers offer such plans in a group policy that meets the requirements of individual members. This means that the insured (you) can get the benefits at prices that is affordable for them.

  • Employers can retain more employees if they provide such benefits like dental coverage. Companies and organizations offering such group dental insurance may be entitled to or may claim tax benefits as a result.

Family Dental Insurance
Family dental insurance is an effective plan created for couples and their children. Such plans may also offer free or low cost service for younger children in your family. Costs for check ups, cleaning, dental x-rays, orthodontics, fillings, and root canals may be lowered as a result of this family dental insurance. Many employers too may offer such a family plan for their employees. If not you can get one on your own.

Family dental insurance has 3 major types:

  • Family Managed Care Dental Insurance – Many individuals go for managed care insurance because the out-of-pocket costs for family dental DHMO and PPO becomes lesser with every visit. However, in this case you need to visit a dentist who is part of the approved network.

  • Family Indemnity Dental Insurance – This plan gives you the liberty to choose the dentist you or your family members would like to visit. There may be a certain amount of deductible that you will be entitled to pay to receive dental care. You and your family will receive more flexibility in terms of benefits and services with this plan.

  • Family Discount Dental Plans – The program under family discount dental plans provides many dental services at lower costs. The advantage of such a plan is that as a member you will be provided with a discount card which you may present to the enlisted dentist to avail the discount.

Total Comments: 52

Posted: Tue May 20, 2008 01:09 am Post Subject: dental

I have ALOT of dental work to be done. My dentist does have Financing, however...I was denied because of my credit. The dentist 'evaluated' everything I needed ( dental wise) and it would be a VERY HIGH payment ( for me, anyway), to them, per month.

Posted: Tue May 20, 2008 01:59 am Post Subject:

Well without a doubt Tricare is great coverage, IM not challenging that, Tricare is one of the best in the health insurance industry... Im arguing the fact that civilians should not pick up a private policy, its worthless...

As for Tricare its one of the best out there hands down.

Posted: Tue May 20, 2008 10:51 am Post Subject: dental

OHH......I see. I din't mean to 'challange' your expertise on this subject, BROKER. I do know what you mean about OTHER Dental plans, however. For a while I think Tricare was for Active Duty only. Have you dealt with Tricare much? I'm VERY surprised some dentists, in my area WILL NOT take it.

Posted: Tue May 20, 2008 07:00 pm Post Subject: dental insurance

...also, I'm surprised to hear SOME of the dentists, in my area, said they won't take Tricare because they ahve had " bad experiences with insurances through the military." Never heard of that before.

Posted: Tue May 20, 2008 07:20 pm Post Subject:

You know Im really not that familiar with Tricare, I sell insurance to retired people, so I do come accross people with Tricare, they are usually happy with it. Very little out of pocket, small copays (if any), and little to no premium.
To my understanding Tricare is through Anthem/Blue Cross Blue Sheild, so its not a matter of government insurance its based on the Anthem Network. Try calling the Consumer Hotline on the Back of your card and see if there are any dentists in your area who are contracted.
Anthem has a pretty good name here in OH, and you should have a PPO, so realisticlly there is a "loose" network if you will. I find it strange that dentists wont accept it.

Posted: Thu May 22, 2008 05:23 pm Post Subject:

Hi! My friend from Origon, search dental insurance too! He recomend this is website! Good luck!

Posted: Thu May 22, 2008 06:58 pm Post Subject:

what s the differernce between this plan and another... they loook the same

Posted: Thu May 22, 2008 11:35 pm Post Subject: dental insurance

Well..........some dentists won't take it AT ALL, in my area. SOME will take it ONLY as a 'supplement' insurance (I pay 'up front' and Tricare pays me back). However......ALOT willtake it as 'regular' insurance ( they bill it DIRECTLY to Tricare). I don't know why some people won't accept it, either.

Posted: Wed May 28, 2008 05:45 am Post Subject:

Sounds like a network problem, call Anthem and get a list of doctors in your area.

Posted: Fri Jun 27, 2008 09:58 am Post Subject:

Hey, what are normally covered under a standard dental insurance plan?

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