When getting health insurance, many of us seek only for covering the costs of treatment for serious medical conditions or accidents, while ignoring the fact that dental insurance is also as important. Dental disease is a very common problem, and covering the cost of treatment can be expensive. Proper dental care plays an important role in your overall good health. For essential safeguards for you and your family, get a dental insurance plan.
Various Plans for Various Needs
There are various dental plans, so you can choose according to your needs and expectations. Knowing the differences are important when selecting a plan and using the benefits. The different plans are as follows:
A dental plan usually involves three parties: you, the dentist, and a third party, responsible for funding and administration of the plan. If your plan is funded by your employer, then an administrator would be responsible for processing and payment of claims. There are three types of third parties.
Choosing your Dentist
Dental plans where you get to choose a dentist: There are plans which allow you to choose your own dentist, while there are other cheaper plans which may limit your choice. The two plans are called open and closed panel plans.
Open Panel: Here the patient can receive care from any dentist, and also any dentist may accept or refuse to treat patients enrolled in the plan.
Closed Panel: Here the covered patients can receive care only from dentists who have signed a contract of participation with the third party.
Paying the Dentist
There are plans where the dentist can be paid in different ways:
Indemnity Plans: Here the insurance carrier charges a monthly premium from the patient and this money gets directly reimbursed to the dentist for his services. The insurance company will pay between 50 percent and 80 percent of the dentist’s fee while the remaining 20 percent to 50 percent is paid by the patient.
Capitation Plans: Here the dentist is paid on a per person basis rather than for actual treatment. A Dental Health Maintenance Organization (DHMO) is a common example of a capitation plan.
Direct Reimbursement Plans: This is a self-funded plan where the employer or a company will pay with its own funds, rather than paying premiums to an insurance carrier or third party. The patient pays the dentist directly, and the employer will reimburse the employee a fixed percentage of the dental care costs, once the receipt showing payment and services received is supplied.
The main difference between medical disease and dental disease is that medical disease can be unpredictable and catastrophic, but fortunately most dental problems are preventable. The key to have healthy teeth is to take preventive care and regular visits to the dentist for checkups and cleanings. This way, the problem can be diagnosed early and fixed, without having to take many tests and also saving on expensive treatments. That keeps the costs of dental care much lower than those of medical care.
Dental plans also cover the patient’s regular checkup, unlike medical insurance which may cover the costs of diagnosing, treating and curing serious illnesses. High quality dental care does not require much of the complex, multiple resources often required by medical care. A thorough checkup by the dentist and a set of x-rays are all it takes to diagnose a problem. As most dental problems can be prevented, dental plans are structured to encourage patients to get their regular checkup which is essential for preventing and diagnosing any serious disease.
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November 26, 2022
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