Types of Dental Insurance Options
There are many types of dental insurance plans that can be roughly separated into the two categories of managed care and fee-for-service. Managed Care dental plans strictly confine the cost and limit the benefits by restricting the type, level and frequency of treatment. These plans do not offer access to the dental caregiver of choice but only listed participating dentists. There are caps placed on the amount of reimbursement for services.
Fee-for-Service dental plans offer more freedom of choice, especially of the dental care provider, and the dentist is paid for each service rendered according to the fees established by the dentist. The cost of premium for each type of insurance reflects the degree of choice and expanded coverage. Dental managed care insurance is administered as a Preferred Provider Organization (PPO) program. Just as will a PPO medical plan, patients select a primary professional from a list of providers who have contractually agreed with the PPO to offer reduced fees. PPOs generally represent the least expensive form of dental insurance available for individual purchase.
When deciding on a PPO the client should review the criteria of providers for the plan whether there are enough dentists to adequately fulfil the needs. Also, make sure to note whether the listed dentists are within a reasonable distance from either your work or home. Ascertain that the PPO provides for specialist referrals. Also, investigate the manner in which emergency treatment is provided.
Another form of managed dental insurance is the Health Maintenance Organization (DHMO) plan. This type of plan pays participating dentists a fixed amount per enrolled family or individual, regardless of the form of treatment. The dentists provide preventative treatment to the patient at no charge. The DHMO plan rewards dentists who keep patients in good health, thereby keeping costs low. The DHMO plan offers direct reimbursement to patients according to the dollar value of money spent on dental care, rather than type of treatment. It allows the client to choose any dentist.
Direct reimbursement is the American Dental Association's preferred method form of dental insurance since it offers the most compressive dental care to the individual patient. In addition to free choice of the dental care provider, the client is also allowed to choose the type of treatment that he or she prefers. For example, a client may choose to have a tooth implant, which is not covered by most PPOs, as opposed to a more cost effective bridge. Preventive care is reimbursed under these plans and should result in overall improved dental health for the participants.
by Sally.Anderson 19 years ago