Having insurance for your dental health is just as imperative as having health insurance and auto insurance. Dental insurance will help you to maintain a healthy mouth, cover the costs associated with expensive oral health treatments, and provide regular screens that can assist in detecting non-dental diseases. We bet you probably didn’t know that a dental health insurance plan was so important to your overall health.
Today we are going to help you discover the best policy to fit your lifestyle. There are four general types of oral health insurance that consist of DHMOs, PPOs, Fee-For-Service, and Dental Savings Plans. You should familiarize yourself with all of these different programs below so you can make the best decision regarding your future coverage.
DHMO stands for dental health maintenance organization. This is typically the cheapest form of dental insurance that you can get. As a member of the organization, you get access to a network of highly skilled dentists. These dentists will provide you with comprehensive dental assistance for little to no cost.
Being a member of this organization requires that you submit a monthly premium payment each month. For this reason, you may hear this program referred to as a capitation plan. This type of policy is great if your have qualified in-network providers in your local area. DHMOs don’t always have access to dentists in every town across the state of North Carolina, so you may have to pay higher out-of-network costs for dental services.
PPO stands for preferred private network. Somewhat similar to the DHMOs, PPOs provide access to a larger network of dentists for their members. These dentists provide services at a reduced cost for all of the organization’s members. You can seek dental care outside of the network, however, it’s going to be significantly more expensive.
One important fact to realize about PPOs is that they do restrict the dental procedures they cover. You may have only a limited amount of services that you can receive a discount on at your local preferred dental service provider.
These are also commonly referred to as fee schedule and indemnity plans. This is the typical type of dental insurance policy that many individuals opt to get. Each carrier will set a certain amount that they will cover for each type of service provided by a dentist. These fees are outlined in a fee schedule.
Your insurance provider will contact multiple dentists in the area to discover the average cost of the dental procedure in your area. It’s important to realize that dental costs vary widely depending on where you are getting your work done at. When the insurance company has the average cost of each service, they will pick a set amount they will agree to cover. This is made into a fee schedule for the clients of the provider.
With this type of plan, you know ahead of time exactly what your insurance company is willing to cover. This can make things very simple to understand. However, one drawback to the fee-for-service insurance policy is that the policyholder typically has to pay upfront for the services performed. Since you are given the option to get dental work done anywhere you would like, the insurance company doesn’t have an account with your provider.
You will need to contact the insurance company and send them a copy of the bill you received from the dentist’s office. They will review the bill and send you a check for the portion of the service that they cover.
The best description for these types of program is to think of them as a loyalty card. When you sign up for the program you receive a discount card. You take that card to any eligible dental office and receive a nice discount on the services you need. In order to gain access to your own dental savings plan card, you will need to pay a monthly or annual premium.
One major advantage to this program is that you don’t have to pay upfront for the entire service, like with the indemnity program. When you go to the dentist you are only responsible for the balance remaining after the discount was applied.