USA- Dental Plans... You Will Be Surprise About Simple Stuff You Don't KnowThere Are 10 Key Questions You Should AskThe 5 Major Types Of Dental Plan CoverageIn America there are 5 major types of Dental coverage, it's very important to know what these are and how they work... ...understand clearly what you are getting yourself into - understand the positives and negatives of all the different types of Dental Plans. You'll learn exactly how each of these 5 Major types of Dental Plans work... I give you solid background information about each type. Remember: 10 Key Questions And 5 Types Of PlansFor your own benefit be familiar with these 10 Key Questions. And it is to your own advantage to know how the 5 Major types of Dental coverage work. Read on - and you will find out.
What Are The 5 Major Forms Of Coverage?'Dental-Plan-Guide': For starters, 4 of the Major Forms of Dental coverage are true Insurance Plans, whereas, Dental Discount Plans are not Insurance Plans, per say... I can see that you, dear guest have a blank look on your face. Let me give you a brief story about how Discount or 'Child Dental Plans' began... ...this should help you clearly understand were I'm headed with all this. Discount Plans Were First Started About 13yrs Ago
The first Dental Discount Plan was started in Dallas, Texas by twin brothers... former Life Insurance Salesmen - mind you. Every where these twins went, they were asked more and more by small business workers and self-employed persons... how or where can they purchase inexpensive Dental coverage.
Self-Employed And Small Business Workers Couldn't Afford......crazy high prices Dental Insurance providers charged THEN - just like you can't afford their even crazier and higher prices NOW! Finally, the twins gave in and said... let's give the people what they want! Even though they knew that providing affordable Dental Coverage would NOT be popular with the Big Boys or the Big Insurance Corporations... they went ahead anyway. I guess you could say they ran the...
O'l Statue Of Liberty Play! - An All American Plan!"Give us your Poor, your Tired, your Huddled Masses" - and your Dentally Non-Insured! And they provided them with comprehensive Dental coverage. Now, today you have... Discount or 'Child Dental Plans' dotting All Across America. Families are in bettter Oral Shape than ever before. Thanks To Those Twin Brothers!Moe: That's a Great Story 'Dental-Plan-Guide', were did you get it? 'Dental-Plan-Guide': Hey, come on Moe. I can't reveal my sources... besides it's my job to know this stuff. Please allow me to finish. Discount Plans or 'Child Dental Plan' were designed to help independent consumers obtain needed dental service...
At An Affordable Price Without The Complicated......Medical or Dental claim forms.
Moe: Thanks for your very insightful and enlightening information, 'Dental-Guide'. Listening to you brought other questions to mind. We want all the information we can get about 'Child Dental Plans', so we can make an informed decision about the type of coverage we want. Dental-Plan-Guide': I'll answer all questions, whether those questions are about 'Child Dental Plans' or not. First, let me let you guys in on a...
'...Little Dental Plan Secret'And it's true - on the surface - if you listen closely to Dental Plan ads, they all are saying... they pay about the same amount for the same procedures, such as:
The Specifics - How 'Child-Dental-Plans' Differ'Dental-Plans-Guide': Some Dental Plans and/or 'Child Dental Plans' - have exclusions, some don't - some have deductibles, some don't, etc. etc. (below, brief description of exclusions and deductibles). Exclusions may or may not be an issue for you. Deductibles may or may not be a problem for you. What is important is that you get a 'Child Dental Plan' that fits your family situation or lifestyle. What you and I need is some sort of measuring stick... some way of judging Plans to ensure you get a Plan that fits your lifestyle or situation. Plans differ primarily in the areas of:
Let's call this our 8 Essential CheckList Points for Dental Plans.
8 Essential Points Leads To Best Possible Dental CoverageWe now have 8 Points or Features for you to judge any type of Dental Plan or 'Child Dental Plan'... ensuring you get a suitable and useful Plan. Remember, if you measure all Dental Plans by these 8 Essential Points... you'll be one Smart Dental Plan Shopper. Moe: That's Great, and... we'll discuss all this and more in even greater detail shortly, when we get to "The 10 Key Questions" you should ask any Dental Plan Provider. For now, let's turn to... The 5 Major Types Of Dental Coverage Are...Moe: Dental-Guide', since you are the Facts - Figures - and Data - Guru......would you mind sharing information with our guest and myself about how exactly does each of the 5 major types of Dental coverage work?
'Dental-Plan-Guide': Moe, you know there is nothing I like talking about more than Dental Plans, or 'Child Dental Plans'. But first, a question for you Moe, how did I become the 'Dental-Plans-Guru'? I don't claim to be a 'Guru' - maybe Smart - but only because I do my homework... ...anyway, I'll be more than happy to give you and your guest a brief run down of the 5 major types of Dental Care Coverage. For simplicity and future reference... I'll base my explanation of the 5 Major types of Plans, on our 8 Essential Points.
Who Could Miss The No's?
When You Add It All UpWhat does all this talk about the different types of Dental Plans - 'Child Dental Plans' - Discount Plans and their NO Restrictions Coverage means to you? Moe: It means that Discount Plans are overwhelmingly tilted in the consumers favor. 'Dental-Plan-Guide': And why is it that Discount Plans are so tilted to provide so many benefits and services for the consumer? Moe: You just explained all that... Discount or 'Child Dental Plans' were created by these twin brothers in Texas for the primary purpose of helping the Independent Consumer - "the little guy". Whereas, the 3 other major types of Dental Coverage were...? Not Designed With Self-Employed Or Small Biz Worker In Mind...instead they were designed with large companies in mind. 'Dental-Plan-Guide': That's exactly right, Moe - and it is worth repeating - Dental Insurance Plans are designed for large corporation and not small business or the Little Guy! Moe: Wow! 'Dental-Plan-Guide... you sure are thorough. 'Dental-Plan-Guide': Thank You... but I'am just getting warmed up.
Because if he needs the services of a Dental Specialist... ...and his Employer Dental Insurance Coverage has Bottomless Loopholes in it - No coverage for certain expensive procedures... ...then a Discount or 'Child Dental Plan would also help him, the corporate worker. As I mentioned earlier, Discount or 'Child Dental Plans' are... Great As Supplemental Dental Coverage Plans'Dental-Plan-Guide': Discount Plans CAN be combined with all other types of plans - no approval is needed by any type of third party administrator - and they are so easy to use. And because Discount or 'Child Dental Plans' are much more comprehensive than Insurance Plans...
Moe: In other words Discount or 'Child Dental Plans' virtually Guarantee you help underwriting the cost of Dental work - regardless of where you work or how complex your Dental situation. On the other end of the scale...
Dental Insurance Plans Have Major Defects
These Defects are known as...LOOPHOLES! What exactly do I mean by Loopholes? Loopholes are exclusions, gaps, restrictions and limitations in Insurance (Dental) coverage. Now, I know no one likes to talk about these Bottomless Loopholes, yet we all know they exist. Moe: "OK, we got that, and we can return to the discussion about 'Bottomless Loopholes' later, but... 'Dental-Plan-Guide': No Moe, I think it's important that we talk about Loopholes Now. I know you want to maintain a clean and positive atmosphere on your website... but I think it's vitally important that your guest get the whole truth - this is for her benefit and protection. Moe: Speaking of her, I believe she is interested in knowing why is this information about Discount or 'Child Dental' Plans seem to be... so carefully hidden from the public? Good question, simple answer. The biggest reason is because of... How Disount Or 'Child Dental Plans AdvertiseDiscount Plans and their 'Child Dental Plan' components are NOT advertised using traditional marketing methods... Human Resource Departments, Television, Radio, Health and Job Fairs.
And why shouldn't Discount or 'Child Dental Plan' advertised by "word or mouth"... they are primarily for independent consumers, as opposed to large third party administrators. And just like with large corporate workers... this doesn't mean third party administrators can't benefit from Discount or 'Child Dental Plans'. Nevertheless, Discount Plans are for people who don't qualify for hefty financial breaks on 'Group Insurance Benefits' or 'Group Dental Plans'. Discount Plans are primarily for companies with less than 150 employees.
Just Keep This Thought In Mind For Now
Here's Your Road Map Around The Loopholes
Moe: These 10 Questions will guide you around and through all the Noise - Mirrors - and Hype - all the stuff you see and read online... ...stuff big Health/Dental Insurance Carriers have always been notorious for, long before the Internet - with their Ever Increasing Rates! At The End Of This Report Or Guide...
Before we turn to the 10 Key Questions, lets look at what we have learned so far about Dental or 'Child Dental Plans. What Have We Learned? We Have Learned That...
Looks Like We Have Learned A Lot!
'Dental-Guide' Will Continue To Provide Expert Commentary
Now For The 10 Key Questions
About These 10 Key QuestionsMoe: These top 10 or Key Questions have come from you and me, the consumer - based on what you and I have shown to our your major concerns with Dental Care Plans... and on... what my research has shown to be key and important information to know. Feel assured - these Key Questions will get you clear ANSWERS to your request about Dental Care Plans.
Let's begin with question # 1...! 1. Does The Plan Allow You To Choose .......Your Own Dentist - Or Does The Insurance Provider Choose Your Dentist?'Dental-Plan-Guide' answer: With PPO's and DHMO's... you must stay within an approved (Insurance Plan) network of dentist. Often these networks range from small to very small. This means... if you don't like the small pool of dentist available for whatever reason - you could be in big trouble.
Something Called A Pre-determination (Pre-authorization) FormIf you need work beyond Preventive care ( teeth cleaning, x-rays, etc)... then your general dentist will be asked to submit a list of required treatment, or your treatment plan to your insurance carrier. When your insurance carrier or provider scrutinizes your Pre-determination form... they will take into account - your deductible - co-payment rate - fee schedule (what they will pay) - your maximums (your dollar caps). I can almost guarantee you... after your Dental Insurance carrier takes all the above into consideration and determines your allowance for your treatment. There won't be much funds left for your dental work... Big O'l Bottomless Loophole! Main Problem With Direct Reimbursement PlansAlong with Discount Plans... Direct Reimbursement Plans of course allow you to choose your own dentist anytime you want. The main problem with DR Plans has to do with their NOT so generous Annual Dollar Cap. If you need a specialist... just remember that specialist fees are very expensive - specialist fees are going to cut into and eat up your DR Plan's Dollar Cap or annual budget real FAST. With DR Plans, once you reach your Cap... you are on your own.
The DR Plan is really Not a bad Dental Plan if you can finance it. Again, I repeat... this is just another Dental Plan or 'Child Dental Plan designed for the big employer - mid-size to large employers.
"You Can Choose And Change Dentists When You Like"But Ah, Discount or 'Child Dental Plans' - some have Networks of well over 25,000 American dentists of all types - Specialists - coast to coast... including Pediatric Dentist.
If you already have a family dentist, there is a good chance your dentist is already registerd with a Discount, or 'Child Dental Plan'.
2. Can You See Your Dentist When You...Want To - Or Need To - Appointment Times Convenient For You?Dental-Plan-Guide answer: If visiting a dentist when you want to is important to you? (I can't imagine how it can not be important to you or anyone else?) Then you should probably think 3 times before you enroll in a DHMO.
Can you imagine paying your hard earned money to a dentist, Dental Plan or 'Child Dental Plan' that is going to tell you what days or... ...Specific Hours You Can Or Cannot Receive Dental Service?Heaven forbids...you want to schedule your child for a dental appointment, and your're a two-working-parent family. You call the Dental HMO - they tell you when you must take off from work - if you want to visit one of their dentist.
What About PPO & Indemnity (Traditional) PlansIn regards to... how cooperative are these 2 types of Plans when it comes to scheduling appointments? Sometimes, it varies with the individual PPO or Indemnity Plan itself... more often, they can and do impose restrictions or limits on when, or how often you can see a dentist, especially within a 12 month period. Nevertheless, they are not nearly as cumbersome with scheduling Dentist appointments as are DHMO's. On the other hand, they don't offer you the complete freedom and flexibility that Direct Reimbursement or Discount Plans (Child-Dental-Plans) offer. With Discount Or 'Child Dental Plans...
You can choose which dentist you want to see - and when you want to see Dentist, provided it's during dentist's regular business hours. See A Dentist At Almost Any Hour Of The Day......on the weeekends, and during times of emergencies.
3. Who Makes The Treatment Decisions......You - Your Dentist - Or The Dental Plan? (Child Dental Plan)'Dental-Plan-Guide' answer: The first thing you need to understand about who makes the Treatment Decisions is this... ...most Insurance Plans (Indemnity, DHMO & PPO) rely on the "Least Expensive Alternative Treatment (LEAT) method. Meaning, if there are several treatment options available for a condition... then the Dental Plan will pay for the least expensive treatment option. With Insurance Plans, if you choose a treatment option that happens to be more expensive and better suited for your Child Dental Care needs than that which the Insurance Plan mandates... you will be reponsible for paying the higher cost difference. With Indemnity - DHMO - & PPO Dental Plans...
On the other hand...
With Discount & Direct Reimbursement Plans...Members Make The Final Treatment Decisions. With a Discount or 'Child Dental Plan', there is NO Need for a Least Expensive Alternative Treatment (LEAT) option. You always qualify for the highest level of care... at the least expensive price.
4. Does The Plan Allow Referrals To Some...... Or All Specialists?
'Dental-Plan-Guide' answer: Most Insurance Plans and/or Third Party Administrators will limit referrals to specialists. I know we touched on referrals earlier... but there is much more to referrals. Understand What A Certain Pool Of Dentist Really Means?Some Dental Insurance policies are structured so that you must choose or seek services from a 'Certain Pool of Dentist'... in reality this means you have a very small pool of qualified specialist from which to choose from. Look for a Plan with a Wide Selection of different types of Specialists - look for a Large Pool of Dentists.
'Child Dental Plans' And SpeacialistsWhile I, the 'Dental-Plan-Guide' and... ...any legitimate Dental Plan Insurer or Broker will recommend that you work with, and seek your primary dentist guidance when choosing a dental specialist's care. Just remember that since specialized treatment is more expensive than routine care... Dental Insurance Plans or Third Party Administrators will Limit and Discourage the use of Specialists.
With that said, here's one more important reason why you should consider a Discount or 'Child Dental Plan', they have... "NO Restrictions Or Limitations Whatsoever"
Again, Discount or 'Child Dental Plans' have NO third party administrators to request permission from.
Just make sure you choose a 'Child Dental Plan' that has specialists in your area, always do a provider search before selecting any Plan.
5. How Much Of The Cost For Diagnostic ......Preventive And Emergency Services Is Covered?'Dental-Plan-Guide' answer: The following services should be covered in full, with NO deductible or patient co-payment:
Remember this - for the most part, you are going to have to assume a portion of cost with any Plan... including a Discount Plan. The point I am trying to make is this... since of course you're going to have to pay something towards your Dental work anyway - why add on to that with a high monthly premium?
This Is An Often Overlooked 'Catch'
Of course with Direct Reimbursement Plans you don't have a monthly premium to pay. But again, I hope you have deep pockets. With a DR Plan, if you have ideas of visiting a specialist... remember, you have to pay full cost for services up-front - and keep an ever watchful eye on your Annual Dollar Cap. Another Strength Of Discount Plans And......their 'Child Dental Plan' component is:
"You Can Visit A Dentist As Often As You Like"
Should you need expensive dental treatment performed... ...then many Discount or 'Child Dental Plan' Dentist are willing to personally negotiate with you for a comfortable payment plan - even after you receive your pre-approved 'Child Dental Plan' deep discount. Often It's Simply A Matter Of Asking Dentist For......a flexible payment plan or additional payment options. When you're working with and paying the dentist directly, instead of some far off impersonal Dental Insurance carrier, then... dentists are more willing to help you out financially - dentist are people, too. To Summarize: 6. What Routine Procedures Are Covered......By Dental Plans And/Or (Child Dental Plans)Dental-Plan-Guide answer: Good question, the problem is... it's very tricky to answer in regards to Dental Insurance Plans. Routine procedures often overlap - look at it like this... Some procedures are covered by general dentists while other procedures are covered by specialists. For example, you will often begin receiving services from a general dentist... then be referred to a specialist to continue, or finish work...
Of course you usually don't find this out until after the initial work has begun, by then you're stuck paying full cost of specialist work.
Let's take a look a commonly accepted routine care procedures:
Know What Portion Of Routine Care Is Covered?Although, Routine Care question is tricky with Insurance Plans... ...it's very simple with Discount or 'Child Dental Plans' as a rule - they tell you up-front what percentage or how much of cost is out-of-pocket. Make No Mistake - Discount Plans Are......Not all the same, either. Even with Discount Plans (Child Dental Plans) - some have gaps in their coverage, too - most do not cover ALL dental procedures - some don't cover all Specialist... ...just like Insurance Plans. Although, with Discount Plans you can find out much easier where you stand at the outset... just ask them. It's easier to get a straight answer with Discount Plan, because of their simple and straight forward structure... just ask what is covered and what is NOT covered?
There Are A Few Fine Discount Or 'Child Dental Plans'......out there, offering you comprehensive coverage - without the restrictions on visits to specialists.
Specialists fees are Discounted 25% ($250. - $3,000.) and higher.
7. What Major Procedures Are Covered...?...By Plan - What Percentage Of Costs Will You Have To Pay?
'Dental-Plan-Guide' answers: Always! Always! Look at what's covered and what's not... along with percent or amount covered by Plan. Commonly Accepted Major Dental Procedures:
Nevertheless, it's important for you to Be Aware of all Limitations when choosing your 'Child Dental Plan' coverage.
"NOT Only Do Dental Insurance Plans Limit Benefits...""...in terms of number of procedures and dollar amount covered in any given year." Often, Dental Insurances out-right refuse to pay for numerous major dental care treatments. >B>Discount Plans Do Not Limit Benefits.
This is an incredible fact within it's own right. And, practically unbelievable when you compare these savings to most Dental Insurance Plans and... their Loophole filled for Major Dental Care coverage. And, it doesn't stop there. Factor In Monthly PremiumsWhen you factor in Premiums or monthly cost of Discount Plans: $10-$20. Whereas, Premiums or monthly membership cost for Insurance Plans: $20-$40
8. Does The Plan Provide Benefits If......You Are Also Covered By Another Plan Or 'Child Dental Plan'?'Dental-Plan-Guide' answer: What we're really talking about here is Supplemental Dental Coverage - the combining of one or more 'Dental Plans in order to obtain complete 'Child Dental Plan' coverage. Are you aware as to why you would want to combine one or more Dental Plans? If you don't know, it's simply because if you have a primary plan that does NOT cover needed Dental Procedure... you then need a secondary Plan to fill-in those Gaps or LOOPHOLES! Call it Loopholes - call it what you like - end result is still the same...
NO Dental Insurance Coverage When You Need It Most...Dental Insurance Plans have Exclusions and Gaps in their coverage, nothing new here. These Gaps and Exclusions may force you to enroll in a second Plan, or get what is know as a Supplemental Dental Plan - or a 'Child Dental Plan', in order to fill these Gaps and Exclusions... get the affordable coverage you want. Supplemental Dental PlansBecause Discount Plans or 'Child Dental Plans' are comprehensive in nature and they have NO Third Party Administrators... ...they can be used in very flexible ways - they can easily be used as 'Child Dental Plans - or as Supplemental Plans. Discount Plans (Child Dental Plans) are... ...NOT regulated by State Insurance Agencies - yet they are widely accepted by licensed Dentist - they CAN also be combined with All other types of Dental Plan coverage without any technical or legal problems. This means that Discount or 'Child Dental Plans' can be used as either Primary or Secondary Dental care coverage.
Remember, Discount or 'Child Dental Plans' Offer Unlimited Visits.
Are Cosmetic Procedures What You Want?Then a comprehensive Discount Plan can be your Savior!
9. What Is The Plan's Policy Regarding Rate......Increases - Open and Closed Season Enrollments?
Dental-Plan-Guide answer: Let's talk open season enrollment first. If you have ever worked for a large company or corporation then you know... ...Healthcare/Dentalcare plans have Open and Closed Season enrollment. This means that if you want to take advantage or your employer-based Dental Care coverge... you have 1 month in the calendar year, to either get in or out of a Dental/Health Care coverage plan.
NOTE OF CAUTION: there are some Discount Plans that only offer you the option of paying by the year. Check closely with these type of Discount or 'Child Dental Plans', most have restriction or penalties, if you decide to opt-out before end of year.
10. Are There Local Providers In My Area?This Is The 10th And Final Question.
'Dental-Plan-Guide' answer: Although, there is NO reason to devote much time to this Tenth Question... this should be the first question you ask. Why? Because, what good does it serve you to search out or research 'Child Dental Plans' online, if they don't have dentist in your area? Simply put, by all means, please do a provider or dentist search before enrolling in any type of Dental Plan or 'Child Dental Plan'.
Broker-Moe...
6 St. Joseph Terrace - Albany, NY 12210 (518) 894-0129
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