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  • Dental Plans & Insurance

    Dental health is a crucial part of our overall persona and well-being. Each passing year, more and more information and information about oral health products and the technologies associated with improving smiles, preventing dental disorders/maladies and treating tooth and gum problems. It’s important that one has dental insurance to cover for a lump of the cost to be incurred if ever a dental malady occurs. Some examples of insurance companies that offer dental insurance coverage are: Blue Cross, Denta Dental and a Metlife. It is important to know that the company you work for covers not just your dental insurance, but your medical insurance as well. The companies mentioned above provide a variety of tailored options for dental coverage to each company/corporation’s needs. If you don’t have a dental insurance plan yet, you can subscribe below to our newsletter to get up-to-date information on the latest news and views for the most reliable dental insurance programs out there.

    More Information about Dental Plans & Insurance

    Important advice on insurance coverage
    Almost every insurance company gives the insured patient the option to pay their dentist in lump and get a reimbursement for the amount paid. Still, some dentists only accept deductible and co-payments coming from patients at the time of the treatment/procedure. That being said, it is still advisable to ask the dentist before setting an appointment if he/she requires a full payment or if he/she accepts dental insurance coverage.

    What if the dental office I go into is on the “out-of-network” list of my new plan?
    It has been a popular issue that when the patient is going to a dental office, the certain practices that office provides is not in the list of pre-approved practices covering their dental plans. Most often than not, these offices accept only a particular type of insurance,  if not, they offer staggeringly low insurance coverage acceptance. For example, a $3,000 yearly maximum for services can be reduced to $2,000 if the patient is signed on an out-of-network provider. It is important to do some research if the dental office you go to and the insurance company you’re signed up in are not at odds with each other.

    What is DMO or a DHMO?
    A Dental Maintenance Organization (DMO) is the one responsible for providing dental care from a team of dentists that generally excels in providing preventive services, and covering qualified services at 100% subtracted by a given co-payment. It does not require the completion of claim forms.  On the other hand, HMO is limited in providing only dental care services which are approved in advance by the patient’s assigned dentist. The plans are usually accepted by a majority of renowned dental clinics/offices that have recently opened up.

    What are the distinct differences of a DMO from a indemnity dental plan?
    A Dental Maintenance Organization (DMO) is limited to providing only care from a network of dentists, which is approved in advance by the patient’s assigned dentist. To be more elaborate, an indemnity dental plan enables it’s actively participating members to gain care from any licensed dentist. These participative members are required to pass claim forms and the plan along with the deductibles and co-insurance. There are numerous ways to create a dental benefits plan. But if the individual characteristics of these various plans differ, still, the common output designs can be delegated into the following categories:

    Direct Reimbursement Programs:
    This program specializes in reimbursing patients a percentage of the amount paid for dental care, regardless on the kind of treatment. This gives the patient the freedom of getting the treatment done by the dentist of their choice.

    “Usual, Customary and Reasonable” (UCR) programs:
    This program basically allows the patients to pick the dentists of their choice. This plan is set on paying a certain percentage of the dentist’s fee or the plan administrator’s fee limit, whichever is less. This limit is agreed upon by the both the plan purchaser and the third-party payer. These plans, having earned the benign term “customary”, still do not or may not reflect the accuracy of fees area dentists are invoicing. The lack of government regulation of this program leaves the “customary” fees in arbitrary positions.

    Preferred Provider Organization (PPO):
    These plans are meant for contracting dentists that agree to give a discount on their fees as a mutual gain for which patients can select their contracting dentist’s practices.

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