Dental Plans - Insurance 101

Types of dental plans

dhmo | indemnity | ppo | scheduled | discount card

Why Get dental coverage?

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DHMO - Dental Health Maintenance Organization

Typically, the least expensive of dental plans . All dental services are provided by professional dentists who agree to provide specific treatements and services to patients at no charge (some services may require a co-payment.)

DHMO plans reward participating dentists who keep patients in good health, thereby keeping plan costs low. Dentists are paid directly by the insurance company for each individual, regardless of how much or how often covered services are used.

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Indemnity

Usually allows the patient to go to the dentist of their choice. These plans generally pay a portion of the dentist's fee or a set dollar amount (usually, whichever is less).

Payments may be made to the insured member or, by assignment, directly to the dentist. If there is a difference between the amount paid and the dentist's full charge and the amount paid, the individual usually pays the difference.

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ppo - preferred provider organization

Generally less expensive than Indemnity dental plans. Individuals select their dentist from a network or listing of dental providers who have agreed by contract to reduce their fees.

Individuals can also seek treatment from dentists outside of the PPO (non-participating dentists) but may be responsible for higher deductibles and/or co-payments.

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Scheduled

A scheduled plan or scheduled reimbursement plan reimburses you for a specific amount based on a fee schedule with any balance due being your responsibility. Scheduled plans do include a calendar year maximum, a deductible and have waiting periods on certain procedures. A Scheduled plan shows every covered procedure and the amount you will be reimbursed for each procedure. For example, if the insurance reimburses $47 for a cleaning, and your dentist charges you $50 for a cleaning, you would be responsible for the difference of $3.

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Discount Card

Discount cards are offered as a way to lower the cost of dental care. These cards are especially attractive for people who do not have insurance coverage for these services or who have inadequate coverage. Discount cards allow for unlimited use of services by using a dental network and are based on a discounted fee schedule. The cost of your membership card is small compared to the potential savings for you and your family.

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Why Get Insurance?

Will You Benefit From Insurance?

People buy dental insurance for a variety of reasons. Here are three of the most common reasons.

  1. To Pay For Costly Care.
    Dental care can be a simple cleaning and x-rays. Or, it can involve costly care from orthodontics (braces) to crowns and oral surgery. Dental insurance generally pays all or a percentage of the charges related to your dental care.
  2. To Maintain A Healthy Mouth.
    Studies show that regular dental check-ups and cleanings help maintain a healthy mouth. That's why most insurance plans pay 100% for check-ups every six (6) months. Some will even cover (pay for) a check-up immediately after you are approved for coverage.
  3. To Protect Their Children.
    From cavities to braces, younger family members will benefit from regular professional dental care. Dental insurance can be a very affordable way to protect against the cost of regular check-ups. Your plan may even pay for more costly care -- even braces.

But, the real question most people ask is
" Will I benefit by buying dental insurance?"

the brief answer:
most likely

There are many forms of insurance. Some, like car insurance, only provide a benefit to the few people who have a costly accident. Some, like life insurance, typically don't provide a benefit for many years. Some, like medical or health insurance, provide immediate benefits, but can be very costly.

Dental insurance is rather unique. First, its low cost makes it highly affordable for individuals and families. Second, because dental insurance encourages and generally pays for regular check-ups, many people who purchase protection start to benefit immediately.

Finally, the price of maintaining a healthy mouth can cost hundreds ... even thousands of dollars. Should you ever need costly care, from filings and crowns to periodontics and orthodontics, your dental insurance will be there to provide benefits when needed.

So, if you buy dental insurance, you will probably use it. And, like millions of Americans who have protection, you'll probably be glad you did.

DentalInsurance.com - Dental Insurance Plans: Individual, Group, Small Business, Family, Supplemental, Student

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