What Type of Dental Plans Have the Best Benefits?
Dental PPO, POS, DHMO Or Fee For Service
Indemnity and managed care dental plans differ in their basic approach. Put broadly, the major differences concern choice of providers, affordable out-of-pocket costs for covered services, and how bills are paid.
Usually, an indemnity dental plan offers more choice of dentists than managed care plans. An indemnity dental plan pays their share of the costs of a service only after they receive a bill.
Managed care plans have agreements with certain dentists to give a range of services to plan members a family at an affordable cost.
In general, you will have less paperwork and lower out-of-pocket costs if you select a managed care-type plan and a broader choice of dentists if you select an indemnity-type plan.
Managed dental plans include Dental PPOs, POSs, and Dental HMOs (DHMOs).
What is a Dental PPO, POS, and DHMO?
A Dental PPO (Preferred Provider Organization) provides dental care to its members through a network of dentists who offer discounted fees to its affordable dental plan members. You can typically use dentists out of the PPO's network, but you will only be reimbursed the discounted fee for the services rendered - you will need to pay any additional amount yourself.
A DHMO (Dental Health Maintenance Organization) provides you dental services through a network of providers in exchange for some form of prepayment. If you use a dentist out of the established network of providers, you may be responsible for paying the entire bill.
A Dental POS (Point of Service) plan allows a member to use either a DHMO network dentist or to seek care from a dentist not in the HMO network. Members choose in-network care or out-of-network care at the time they make their dental appointment and usually incur higher out-of-pocket costs for out-of-network care.
What is an Indemnity Dental Plan?
An indemnity dental plan is commonly known as a fee for service or traditional plan. If you select an Indemnity plan you have the freedom to visit any dentist. You do not need referrals or authorizations; however, some plans may require you to pre-certify for certain procedures.
Most indemnity plans require you to pay a deductible. After you have paid your deductible, indemnity policies typically pay a percentage of "usual and customary" charges for covered services; often the insurance company pays 80% and you pay 20%. Most plans have an annual out of pocket maximum and once you've reached this they will pay 100% of all "usual and customary" charges for covered services.
Many dental indemnity plans also require a waiting period before covering certain services.
+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.
Choosing Family Dental Insurance For Your Child
I'm sure you've noticed that you and your child are two distinct people with entirely different needs, including dental health needs. When employers label children as dependents, however, they often see them as extensions of their parents. That means when it comes to awarding family dental benefits, you must be on the same policy. It's important to be sure you select a dental plan that works for both of you. Here are some things to consider when choosing your dental insurance carrier:
- Your child has the right to see a pediatric dentist. Pediatric dentists are specially trained to address the unique dental needs of young children, such as early preventive care and alleviating dental anxiety. If your family dental insurance plan only allows your child to see a pediatric dental specialist after an unsuccessful visit to a general dentist, consider making a change.
- What is the extent of your preventive care coverage? Children's teeth are in a critical stage of development. Any potential problems should be identified and resolved as early as possible. It's also crucial to establish positive dental care habits right from the start. This means dental exams early and often. If your dental plan puts unreasonable restrictions on a child's early dental care, look for dental coverage elsewhere.
- What other procedures are covered? As mentioned, your child's teeth are only just developing. If they do not grow properly, your child can experience pain or misshapen facial structure. Special care, such as orthodontics, is often required to correct the problem, and is often medically necessary. If your family dental insurance plan considers this specialized care to be cosmetic, and therefore not covered, look for something better.
- What is the extent of your emergency care coverage? Kids have accidents - it's a fact of life. Not only are they generally more active than many adults, playing sports and climbing trees, but many have not yet developed refined coordination. That means plenty of falls or balls to the mouth. If your child loses a tooth or experiences some other sort of dental trauma, be sure your plan allows you to seek immediate emergency care without anybody's permission.
- It's important for you to have a reasonable amount of control over your child's dental care. If your dental insurance company makes it difficult to choose or change dentists when you feel it's necessary, or allows you very little say in whatever treatment is performed, shop around.
Insurance may seem like a costly investment, but a family dental plan that truly fits you and your children's needs is well worth it. The preventive and emergency care you'll receive will ensure all of you will enjoy good oral health for a lifetime.
+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.