Dental Insurance and Capitation Scheme
Do you think you’re not getting your money’s worth from your dentist? Perhaps you feel like you can no longer afford to always pay for your dental consultations and treatments? If these are the cases, then may be it’s him time for you to avail of private dental insurance policies.
What can you get from dental insurance plans? First of all, dental insurance policies are more flexible. Some dental insurance companies will allow you to maintain your own dentist and still shoulder your expenses, however, at a much lower cost. Others have their own list of affiliated clinics and doctors. Though your choices can be limited, still, you can select among them whom you prefer, depending on your own varying factors, perhaps the location, name of the doctor and clinic, and the available services in the clinic. If you still prefer to go for the services of your own dentist, you can just simply ask for reimbursement from the insurance company.
Now, how about for the extent of coverage for the dental insurance? First of all, dental insurance companies do not actually pay the actual cost of the treatment. More often than that, they are only willing to shoulder a percentage of it, perhaps 75 percent, depending on the annual maximum amount the company has given you. Normally, you are required to enroll in a dental insurance policy at least three or even six months before you use the plan; however, this may vary, so it’s better to ask your insurance agent first.
Most dental insurance policies cover for the payment of root canal treatment, general treatment of crown, dentures, bridges, as well as laboratory tests, as long as they are still under your annual limit. Emergency treatments are also made available; however, cosmetic dental procedures like implants and braces are not allowed, as well as surgical procedures for root removal, oral cancer, salivary glands treatment, and dental abscesses.
As a client, you can also go for the capitation scheme. By this, we mean you are allowed to pay your premiums every month rather than the whole bill all the time. Usually, premiums can already be determined once you are done consulting a dentist. This premium then covers the following: x-rays, extractions, regular treatment, check-ups, and teeth fillings. Capitation schemes are therefore ideal when you have healthy teeth and all you have to do is to maintain them.
There are actually a lot of providers for capitation schemes, and one of them is the Denplan Care. This organization has policies which are priced according to the dental service you availed or trying to avail, as well as the overall condition of your teeth.
One great disadvantage of the capitation scheme is that you cannot choose your own dentist or clinic. You are only allowed to undergo consultation or treatment to clinics that have agreed to the scheme. Hence, if you are into the capitation scheme and your doctor isn’t, you may opt to either let go of the latter or forego the former.
by Maria-Goldsmith 19 years ago