The Things
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| Then you know, getting your hands on "telling"... or useful information on the major types of dental-benefit-providers and how they operate can be about as difficult as... |
"Trying To Bite Your Own Teeth"
In response to your difficulty obtaining "telling" info... about the various types of American dental providers and their plans, I've developed...
| A simple 7 Point CheckList that guides you through the process of selecting the type of dental provider suitable to you, your family, or business needs and wants. Highlighting the most important features offered by the 5 major types of dental providers. |
We'll get to our checklist shortly, but first, you should know about a dental-benefit-providers... "little secret"!
Well actually, it's not such a "little" secret... anyway, here it is...
"There's really NOT much difference in the amount of savings or discounts a consumer receives on covered or insured procedures by the various major dental insurance providers".
The Key Word Here Is COVERED - Here's What I Mean...
| Do NOT measure the value or difference in dental-benefit-providers coverage by HOW MUCH they pay towards cost of procedures. Measure their worth by HOW MANY procedures they cover... especially if you have a family! |
Can You See Why This Is Important... If Not Let Me Explain?
Because dental-benefit-providers (the majority), pay about the same amount towards most procedures... especially those procedures known as "usual and customary"...
...and they'll continue to do pretty much the same thing even after the new Health-Care Bill takes affect.
"If You Look Only On The Surface..."
...dental-benefits-providers all look about the same. And why shouldn't they, I mean they all say they pay pretty much the same amount for customary procedures, such as:
- Most providers make payments or give you savings ranging from 80% to 100% ($52.- $125.) on preventive work (teeth cleaning, check-ups, x-rays, etc.).
- Most providers cover or save you between 25% - 65% ($140.- $600.) on restorative and *cosmetic work (fillings, crowns, bondings, etc.)(*most plans don't cover cosmetic procedures).
- Most providers cover or save you anywhere from 25% - 50% ($125.- $3,500) on *specialist work or major dental care procedures (bridges, braces, implants, etc.) (*not all plans cover specialist's procedures).
Just remember, we're talking about payment amounts for the most commonly known dental procedures.
Now let's look at...
When you look beyond coverage for basic procedures (customary procedures), or below the surface at more complex procedures like cosmetic procedures...
...you begin to see how dental-benefit-providers differ, and differ do they ever, in regards to which procedures they'll cover beyond usual and customary procedures.
Understand this...
ALL Dental Benefit Plans Have Some Sort Of...
Exclusions... deductibles... restrictions... or a combination of all 3 features.
What's excluded, deducted, or restricted is different with different providers or plans... I doubt if this comes as a surprise.
| Some dental benefit plans have deductibles, some don't. Some have exclusions and restrictions... some don't... so on and so on, (see below for description of exclusions, deductibles and restrictions). |
Again Why Is This Important To You?
Because, take deductibles for example... certain types of dental plans have deductibles as high as $500.
If you're on a tight family budget... you certainly don't need a dental plan like that, with a high deductible.
| My attempt is to help you get beyond the hype you see everyday on the internet... so you can see beyond the smoke and mirrors and select the type of plan or coverage that's right for your family situation. |
There are 5 Major Types or Categories of dental-benefit-providers...
Dental-benefit-providers 5 major categories or types:
- Dental Indemnity (Traditional) Insurance Plans.
- Preferred Provider Organization Plans (PPO).
- Dental HMO's or (DHMO) Plans
- Direct Reimbursement Plans(DR)
- Dental Discount Plans (DDP)
"Let's Use Our 7 Point CheckList On 5 Provider Types"
Checklist focuses on what's really different and important... what to pay special attention to with each different type of dental plan or provider:
- Direct Reimbursement - fee for service plan, self-funded type dental plan, reimburses patients according to dollars spent on dental services or dental work - offered by employers.
7 Essential Points or Features:
Deductible -- Yes, $200. - $500. (varies widely)*
Exclusion on pre-existing conditions -- No
Waiting period -- No
Limits or cap on yearly visits -- No
Limited access to specialists -- No
Annual dollar cap -- Yes, $1200. - $1500
Monthly cost* -- None.
Dental Discount Plans - membership plans, like a giant buyers clubs. Members afforded access to all types of dentists and specialists. Guaranteed deep discounts on most all procedures.
7 Essential Points or Features:
Deductible -- No
Exclusions on pre-existing conditions -- No
Waiting period -- No
Limits or cap on yearly visits -- No
Limited access to specialists -- No
Annual dollar cap -- No, (none)
Monthly cost -- $12. - $24. per household/family.
Dental Indemnity Insurance - your traditional dental insurance plan, high monthly premiums, flexible but most expensive type plans.
7 Essential Points or Features:
Deductible -- ($150.- $300.)
Exclusions on pre-existing conditions -- No
Waiting period -- Yes, 6 mo. on most services.
Limits or cap on yearly visits -- Yes
Limited access to specialists -- No
Annual dollar cap -- Yes, $1000.- $1500.
Monthly Cost -- $45.+ per family
Dental Preferred-Provider-Organizations (PPO) - another true dental insurance plan, a group of dentist agree to offer their services to a "third party administrator" at a discounted rate.
7 Essential Points or Features:
Deductible -- ($150.- $300.)
Exclusions on pre-existing conditions -- Yes
Waiting period -- Most have them
Limits or Cap on yearly visits -- Yes
Limited access to specialists -- Yes
Annual dollar cap -- Yes, $1000. - $1500.
Monthly cost -- $30.+ per family.
Dental HMO (DHMO) - also a true dental insurance plan, also known as "Capitation Plans," operates very much like their health-care HMO sister. Known for using tactics to discourage patient visits.
7 Essential Points or Features:
Deductible -- Yes, may have to pre-pay 1 full yr premium
Exclusions on pre-existing conditions -- Yes
Waiting period -- No
Limits or cap on yearly visits -- Yes
Limited access to specialists -- Yes
Annual dollar cap -- Yes, $500. - $1200.
Monthly cost -- $20. - $40 per family
* Notice all these NO's for Discount Plans
If a dental-benefit-provider tells you NO...
...it usually means some sort of limitation. It usually means you are being denied some sort of dental coverage you want.
In other words...No usually means hearing - NO we don't pay for those procedure, or - NO we won't pay for that service, so on, and so on.
But in this particular discussion about dental-benefit-providers... take a second look at why...
"Discount Plans" NO's Mean Something GOOD For You!
| And if NO means something good... when it comes to dental coverage... then it looks like dental discount plans give us more of a good thing than any other type of dental-benefit-provider. |
Plain and simple, here's what I mean...
"Discount Plans" As Opposed to "Dental Insurance Plans"...
...offer you positive NO's ... NO Limits - NO Caps - NO Restrictions - NO LOOPHOLES!
and Ultimately...
"More complete and comprehensive dental care."
| Believe it or NOT ... "this dental discount plan covers All 353 medically recognized dental procedures. And you can visit a dentist in only HOURS after enrolling in plan" - Honest! |
Now that's comprehensive and convenient coverage.
To Fully Appreciate Their Comprehensive Coverage...
...you should know in terms of number of procedures covered... the recommended dental plan next closes competitor covers only a 147 dental procedures.
If you have information to the contrary or to add to this... then please e-mail me that info.
In the meantime, if you're interested in comprehensive and affordable dental coverage...
Then Do Visit The Discount Plan Leader's Website
Again...
This is the only discount plan of many discount dental-benefit-providers I know of... that actually covers every SINGLE dental procedure in the book And then some (like new hi-tech oral cancer detection procedures).
There you go...
A Brief Rundown On Dental-Benefit-Providers And Their Plans
Solid background info on dental-benefit-providers... using our 7 essential CheckList features.
And of course, my recommendation to an absolutely great discount dental benefit plan.
I hope this helps, and...
Broker-Moe...
"...brings you insiders savings tips on Dental Care!"
6 St. Joseph Terrace - Albany, NY 12210
(518) 255-5596