Dental Plans Considerations
Sunday, April 12th, 2009 Subscribe To Our Feed
What do you look for when you are considering dental plans? Obviously if you can get a dental plan through your employer, that will be your first choice. However many employees receive no health cover and even if they do, these plans often do not include dental. Providing care for your family and yourself falls on your shoulders.
If you are able, then you need to review the many types of dental insurance. The most commonly chosen type is purchased through a Preferred Provider insurance organization (PPO). PPO's offer coverage to patients who are willing to work through the company's covenanted list of dental professionals.
There are distinct advantages to this. A PPO provider has a vested interest in balancing costs and professional standards, maintaining a reliable stable of professionals in association with them, and providing a clearly defined set of services through those professionals.
PPO’s are considered a form of managed health care, and there are a range of similar dental insurance plans, including DMHOs and closed panel plans. The primary thing to establish if you choose a PPO is whether you are allowed to make use of professionals who are not within their network, and under what circumstances permission for non-network professionals would apply.
Dental plans that allow referrals for specialized work, for example, might allow you to use a non-network specialist if you were referred by a network affiliated primary dentist. Likewise some dental insurance allows for the use of non-network professionals if there are no network professionals within a certain mile-limit from your residence.
The second most likely form of dental health insurance you are likely to purchase outside the employer provided dental plans, is one of a number of forms of dental indemnity plans, most called that specifically. A dental plan that is indemnity based will usually allow you to choose your own provider, and will then pay a percentage of the cost over and above the deductible payment you make going in.
A payment of 80% of “usual and customary” costs is fairly standard. A word of warning: sometimes the company can argue over claims it feels are not "standard" either by cost or type of service.
Either form of dental plan offers a range of variations…particulars can be found on various sites online. Whichever plan you select it must cater for the needs of you and your family. A managed dental plan usually costs less and will offer great choice of cover. An indemnity plan is more likely to be expensive, but will offer you a wider range of dental plan providers and services.
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