Understanding Your Dental Plan
Understanding your dental coverage can be a confusing process if you do not know the basics about dental insurance, before seeing your dentist.
A dental insurance plan is a contract held between your insurance company and you; generally these plans are coordinated by an employer and details for the plan are negotiated between the company and the employer.
While you might not have a say in what kind of coverage your plan offers, you will generally have a say in which dentist you choose to go to.
Dental insurance plans vary depending on the company and the coverage, but the four basic kinds of dental plans are direct reimbursement programs, preferred provider organizations, capitation plans, and indemnity plans.
To help you better understand your dental insurance before trying to find a dentist, consider the various dental plan types.
Direct Reimbursement Programs Just as it says in the title of this dental coverage, the direct reimbursement program is a plan where your employer directly reimburses you for part or all of your dental treatment.
Generally speaking, all treatments and procedures are covered by your dental plan and you can find a dentist that you prefer for treatment.
While this type of dental plan might not be convenient for people who are tight on cash, it is extremely convenient for those who want to hand-select their dentist.
Preferred Provider Organizations With a preferred provider organization dental plan, you have to choose a dentist from a group of dentists who have agreed to provide their services at a discounted rate so they can be a part of the organization.
This type of dental plan allows someone who does not currently have a dentist to find a dentist from a list of providers and remain with the same dentist throughout their time under the dental plan.
Capitation Plans A capitation plan, also known as a dental health maintenance program, is a program where participating dentists are paid per patient enrolled in the plan.
For each patient enrolled in the plan, the dentist is paid a set amount of money, regardless of the number of times a patient visits the dentist.
If one patient visits every three months and another patient visits once a year, the dentist is paid the same amount regardless of the treatment received.
This type of plan may or may not benefit the dentist enrolled in the plan because some patients require a lot of treatment, while others never find a dentist.
Indemnity Plans Indemnity plans are the most common type of dental plans.
Sometimes these plans are called UCR programs; UCR stands for "usual, customary, and reasonable.
" With the indemnity plan, you can find a dentist that is perfect for you, pay on a traditional fee-for-service basis, and then the insurance company reimburses you between 50 and 80 percent of the dentist's fees.
Your employer pays the insurance company a monthly premium to ensure a reimbursement from the insurance company.
The remaining 20 to 50 percent is generally the patient's responsibility, after the deductible established by the employer and the insurance company is met.
While you might not fully understand the basics of your dental plan, knowing the basics of dental insurance can help provide you with knowledge about what you will encounter when trying to visit the dentist.
If you have dental insurance through your employer, generally your employer can help you understand the process for finding a dentist and cashing in on your dental plan if you are still unsure about the basics.
By understanding the various forms of dental plans and dental insurance types, you can be better prepared when you try to cash in on your dental plan.
A dental insurance plan is a contract held between your insurance company and you; generally these plans are coordinated by an employer and details for the plan are negotiated between the company and the employer.
While you might not have a say in what kind of coverage your plan offers, you will generally have a say in which dentist you choose to go to.
Dental insurance plans vary depending on the company and the coverage, but the four basic kinds of dental plans are direct reimbursement programs, preferred provider organizations, capitation plans, and indemnity plans.
To help you better understand your dental insurance before trying to find a dentist, consider the various dental plan types.
Direct Reimbursement Programs Just as it says in the title of this dental coverage, the direct reimbursement program is a plan where your employer directly reimburses you for part or all of your dental treatment.
Generally speaking, all treatments and procedures are covered by your dental plan and you can find a dentist that you prefer for treatment.
While this type of dental plan might not be convenient for people who are tight on cash, it is extremely convenient for those who want to hand-select their dentist.
Preferred Provider Organizations With a preferred provider organization dental plan, you have to choose a dentist from a group of dentists who have agreed to provide their services at a discounted rate so they can be a part of the organization.
This type of dental plan allows someone who does not currently have a dentist to find a dentist from a list of providers and remain with the same dentist throughout their time under the dental plan.
Capitation Plans A capitation plan, also known as a dental health maintenance program, is a program where participating dentists are paid per patient enrolled in the plan.
For each patient enrolled in the plan, the dentist is paid a set amount of money, regardless of the number of times a patient visits the dentist.
If one patient visits every three months and another patient visits once a year, the dentist is paid the same amount regardless of the treatment received.
This type of plan may or may not benefit the dentist enrolled in the plan because some patients require a lot of treatment, while others never find a dentist.
Indemnity Plans Indemnity plans are the most common type of dental plans.
Sometimes these plans are called UCR programs; UCR stands for "usual, customary, and reasonable.
" With the indemnity plan, you can find a dentist that is perfect for you, pay on a traditional fee-for-service basis, and then the insurance company reimburses you between 50 and 80 percent of the dentist's fees.
Your employer pays the insurance company a monthly premium to ensure a reimbursement from the insurance company.
The remaining 20 to 50 percent is generally the patient's responsibility, after the deductible established by the employer and the insurance company is met.
While you might not fully understand the basics of your dental plan, knowing the basics of dental insurance can help provide you with knowledge about what you will encounter when trying to visit the dentist.
If you have dental insurance through your employer, generally your employer can help you understand the process for finding a dentist and cashing in on your dental plan if you are still unsure about the basics.
By understanding the various forms of dental plans and dental insurance types, you can be better prepared when you try to cash in on your dental plan.