"DENTAL-PLAN-CARRIERS...
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| There are 7 key or important questions you should ask carriers before you enroll your family... or business in any of their dental plans. |
What are the 7 key questions?
1. "Does Dental-Plan-Carrier Allow You To Choose Your Own Dentist...Or Does Carrier Choose Your Dentist?" 2. "Can You See Your Dentist When You Want To... Need To... At Appointments Times Convenient For You?" 3. "Who Makes Treatment Decisions... You, Your Dentist... Or Dental Carrier?" 4. "Does Dental Carrier Allow Referrals To Some... All, Or No Specialists?" 5. "How Much Of The Costs For Diagnostic... Preventive... And Emergency Services Are Covered By Carrier?" 6. "What Routine Dental Procedures Are Covered By Carrier?" 7. "Which Major Dental Procedures Does Carrier Cover... And What Percentage Of Procedure Cost Will You Have To Pay?"
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The Answers To These Questions ...
Will guide you in choosing a dental plan that's right for you...
your family... or business needs.
Before we get started answering these 7 questions...
let's make sure you're familiar with the names of...
The 5 Major Types of Dental Plans In America
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My answers will touch on how these 5 major dental plans are similar... and how they're different in their coverage.
Ok, let's get started with question 1.
Answer: With DPPO's and DHMO's... you must choose within the dental-plan-carriers approved network of dentists.
| Often these networks range from small to very small. Make sure you like the DPPO or DHMO pool of dentists before you enroll in any of their plans . |
If You Go Outside Of A DPPO or DHMO Network...
...without prior approval... you'll be responsible for entire payment... for any and all dental treatment and services you obtain.
| Indemnity, Dental-Discount and DR Plans allow you complete freedom to choose your own family or general dentist. |
Answer: If visiting a dentist when you want to is important to you? (I can't imagine how it can NOT be important to anyone?)
Then you should probably think twice before you enroll in a DHMO plan.
| DHMO's instruct their dentists to intentionally make patients wait before they can access dental services. These plans are designed and structured to deter you from visiting and obtaining in-dept dental treatment. |
DPPOs Impose Restrictions Or Limits
...on how often you can see a dentist within a 12 month period.
Indemnity and DR Plans allow you to schedule appointments and visit dentists when you like.
Although, Indemnity Plans Do Have Limits
...on the number of yearly dental visits they will allow... or help you pay for.
DR Plans have a dollar amount cap... on the number of yearly visits they will reimburse you for.
Discount Plans have no limits on number of yearly visits... and no dollar amount cap on treatment costs.
Answer: Indemnity, DHMO & DPPO rely on the "Least Expensive Alternative Treatment (LEAT) method.
| Meaning... Indemnity, DHMO and DPPO plans will only pay for the least expensive treatment option... even if there's a better treatment option available for your condition. |
Let's make this clear...
If Your Dental-Plan-Carrier Uses The LEAT Method...
...and you choose a treatment option that happens to be more expensive and better suited for your dental care needs... than what the dental-plan-carrier mandates.
Then you'll be responsible for paying the higher cost difference!
Discount Dental-Plans and Direct Reimburse Plans...
...allow members or enrollees to make the final treatment decisions. Although, you may not be very familiar with these 2 types of dental plans... don't dismiss either lightly... now is the time to find out more about them.
| A Discount Dental or Direct Reimbursement Plan...depending on your particular circumstances... may be the plan for you. Of course, a lot depends on what you're looking for. |
Answer: For the record, any legitimate dental-plan-carrier... health insurer, or Broker... will recommend you work with and...
...seek your primary dentist guidance or referral before choosing a dental specialist's care.
With that said, remember this, since...
Specialized Treatment Is More Expensive Than Routine Care...
| DPPO's, DHMO's and Indemnity dental-plan-carriers... for the most part...limit and discourage the use of specialists care. |
So by all means... do check and...
Consider Well The Dental Plan's Specialists Coverage
If there's such a thing as a "SECRET" to choosing between competing dental plans... it would be this...
| "How comprehensive.... is the dental-plan-carriers coverage for specialists treatment? Which type of specialists are covered and which ones are not?" |
With Direct Reimbursement Plans?
You don't have to jump through hoops in order for DR dental-plan-carriers to pay for specialists treatment.
You will need deep pockets though... because you'll have to pay for treatment or services first before these type plans reimburse you.
A Select Few Dental Discount Plans Will...
...cover ALL specialists and all major dental procedures.
| I say a select few dental discount plan... because specialists coverage varies widely among individual discount plans. It all depends on how comprehensive the coverage of the individual discount plan. |
Answer: You probably already know... diagnostic and preventive treatment are your least expensive services.
Most dental-plan-carriers pay for most, or all cost associated with preventive and diagnostic services.
| 4 out of the 5 major dental plans (excluding DR Plans), pay cost or provide discounts ranging from roughly 80% to 100% on preventive work... teeth cleaning... x-rays... check-ups. |
Things get a little tricky...
When It Comes To Emergency Services
Unless it's an abscessed tooth...or a tooth that's needs pulling... coverage for emergency dental services can vary widely with the different dental-plan-carriers.
| Most dental-plan-carriers are reluctant to pay for emergency services... such as a sport injury... or an accidental injury. |
For the most part... dental-plan carriers push cost associated with dental emergencies onto health insurers or health carriers.
Answer: What's considered a routine procedure can vary widely from dental carrier to dental carrier.
Often what starts out as a routine procedure overlaps into specialist treatment... look at it like this.
| Dental-plan-carriers or insurers... will usually cover the less expensive work performed by the general dentist... while they often refuse to pay for the more expensive work performed by the specialist. |
This is usually...
How Patient Conflicts With Dental-Plan-Carriers Develops...
...over recommended specialist work began by a general dentist.
For example... a patient may begin receiving services from a general dentist... say for a dental bridge repair.
Later this patient is referred to a specialist... by the general dentist... to get a dental implant.
| Again, the problem here is... dental-plan-carriers will provide coverage only for general dentist's work... but NO coverage for specialist's work. |
This is actually a great example of...
Why Dental Discount Plans Have...
...grown in popularity over the last few years.
A top rated discount plan covers ALL dental procedures... whether performed by a general dentist or a specialist.
| Simply put... with any dental discount plan you don't have to haggle with the dental carrier over coverage or payment for ANY type dental procedure. |
Tip: This is one of the reasons why a DDP is my personal preference.
Answer: I guess in some ways I'm going to repeat myself in answering this question... especially since specialists and major dental work are often one it the same.
Nevertheless, I think it's important for you to hear these answers from slightly different angles.
Limitations Are The Name Of The Game
...when it comes to dental-plan-carriers coverage for major dental procedures.
| As a rule... dental-plan-carriers cover less than 50% (if they cover anything at all), of the cost of major dental treatment. Things such as dental bridges... braces... restorative crowns and so forth. |
When it comes to carrier payment towards a sought after major dental procedure...
...make sure you find out if a percentage of cost... or a specific dollar amount of cost will be paid towards procedure.
"Are You Currently Interested In Major Dental Work?"
If you are interested in major dental work...including cosmetic dental work? If so, I'm compelled to share the following with you.
| This top rated discount plan covers All major dental work... including ALL cosmetic dental work. Veneers... implants... lasik procedures and more. |
In other words... if you want some cosmetic dental work... or a 40 to 50% discount on major dental procedure?
Then do visit the link below to...
There you go...
Finally, we're finished!
I hope I've been of some help, take care and...
Broker-Moe...
"...brings you insiders savings tips on Dental Care!"
...on my other pages in box below.
6 St. Joseph Terrace - Albany, NY 12210
(518) 225-5596
