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.
Selecting an Affordable Dental Plan for Your Family
What is the best and most affordable family dental insurance plan for me?
Finding a family dentist and an affordable dental plan can be a confusing experience. Although there is no one "best" affordable dental plan, there are some plans that will be better than others for you and your family dental insurance needs. We will try to guide you in simple terms. However, rather than just giving you answers, the best thing we can do is to make sure you are equipped with the right questions.
There are three major things to consider, each with their own unique set of questions. By considering the questions thoroughly, you will arrive at the right and affordable dental plan for you and your family.
- How affordable is the plan (cost of care)?
- How much will it cost me on a monthly basis?
- Should I try to insure just major dental expenses or most of my dental expenses?
- Can I afford a policy that at least covers my children?
- Are there deductibles I must pay before the family or individual dental insurance begins to help cover my costs?
- After I have met the deductible, what part of my costs are paid by the family dental insurance plan?
- If I use dentists outside a plan's network, how much more will I pay to get care?
- How often do I visit the dentist and how much do I have to pay at each visit?
- Does an affordable dental plan include services that match my needs (access of care)?
- What other dental providers are part of the individual or family dental insurance plan?
- Are there enough of the kinds of dentists I want to see?
- Where will I go for care? Are these places near where I work or live?
- Do I need to get permission before I see a dental specialist?
- Are there any limits to how much I must pay in case of a major illness?
- Is the prescription medication which I need covered by the dental insurance plan?
- Have people had good results when covered by a specific, affordable dental insurance plan (quality of care)?
- How do independent government organizations rate the different dental plans?
- What do my friends say about their experience with a specific plan?
- What does my dentist say about their experience with a specific dental plan?
If you consider these elements carefully when choosing a affordable dental insurance plan, you can be assured the best possible outcome.
+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.