Hmo Insurance Plans - In Your Local Area

Managed Dental Plans

"Managed" dental care is a great idea.

However, many dentists strongly feel that it should be "managed" by their patients, for their benefit - instead of by a dental insurance company for its benefit.

If you are covered by a dental insurance plan, and if your employer offers you a range of different programs, the time you spend investigating benefits will be time well spent. Doing so puts your family in control of the quality of dental care you can demand and receive from your dental coverage.

Words can have very different meanings, depending on an individual's point of view. Some low cost dental insurance plans restrict patients to "preferred providers" of dental care. That sounds impressive until you recognize that providers are "preferred" by the insurer, not necessarily by you. And in many cases they're preferred, frankly, because they agree to sell their services at a discounted rate.

Review your own insurance options carefully: some dental plans allow participants to continue receiving optimum care from their current physicians and dentists. Some don't. It's your choice.

The idea of solving dental health problems "at no (or minimal) cost to you" is understandably appealing. But recognize the tradeoff. Simply put, it's "little cost and less choice."

+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.

Dental Fees

Fortunately, in these times, a lot of patients have dental insurance. Insurance is, on the face of it, a good thing. It minimizes out-of-pocket expenses for treatment and encourages people to keep up with the dental care they need. But most dental insurance plans do not pay 100%. There simply is no perfect insurance plan.

Part of the problem is what's called "usual and customary fees." Insurers have come up with a fee structure intended to reflect the "average" cost of "average" dental care. Urban residents may be allowed different compensation than people who live in rural areas. Reimbursement for a crown may be a certain percentage of the actual cost (the dentist's charge to you), and another percentage for a cleaning. Patients are sometimes puzzled at the discrepancy between insurer reimbursement and actual dental fees.

Of course your dentist can't dictate the amount your dental insurance plan decides is "average." And they don't ask your dentist what cost he or she thinks is fair. The dilemma is this: your dentist can't, in good conscience, recommend less than quality dentistry, even though your insurer may impose an unreasonable ceiling on treatment. It's a rock and a hard place.

For this reason, you should take objections directly to the insurer or compare dental plans with your employer. If enough people make enough noise, the reimbursement picture might improve.

Ask your dentist to sit down with you and go over your dental plan and your dental financing options. He or she will try to make your dental insurance plan work to your advantage. Your dentist cares about your finances, and your health.

+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.