Metropolitan Dental Insurance - In Your Local Area

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.

My Dental Plan: Maximizing the Benefits of Your Dental Plan

The new dentistry brings together a unique complement of skills, knowledge, and capabilities with one primary focus: ensuring your dental health. Working as a team, your dentist and the dental team he or she has assembled wants to recruit you to join them in making sure this focus on new dentistry is maintained you get full value from your dental health plan.

The dental team has two major parts that you may hear referenced during your visits: the "back" and the "front." These terms refer to two very specific functions of your dental team. The front office handles all the administration, scheduling, dental plans, insurance and financial details, and the back office provides the treatment.

Your front office team makes sure you know about scheduling opportunities, handles finances, files with your dental plans and keeps the administrative details under control to provide you efficient services and support. The back office team is thus free to do what they do best: provide the best care and service for you. You'll find the dentist, dental hygienist, and dental assistant ready to assist you during your appointments.

The key component for success of any team is each member's commitment to do their part. As a consumer and team member, your commitment to new dentistry involves three things:

1. Maintaining your commitment to your dental health through regular hygiene appointments and the daily practice of flossing and brushing.
2. Asking questions and getting the essential information you need about your teeth and gums or to understand any treatment plans.
3. Staying open to options and opportunities that the new dentistry offers you by thinking about the information and feedback that your dentist provides you about the status of your dental health and dental plans.

You can maximize the dental plan benefits with the skills and expertise of your dental team by deciding for yourself what kind of relationship you want with your dentist and the dental team and how they can help you achieve a positive outcome for your dental future.

By Brian DesRoches, PhD

+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.