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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.

Five Things To Know When Choosing a Dental Insurance Plan

You've heard time and again that dental insurance can protect you and your family from dental and financial catastrophe. Even cheap insurance with minimal coverage will most likely save you big bucks over the course of your lifetime. A quick Web search will show that insurance is big business, and your options are becoming more expansive - and complicated - by the day. Not sure where to begin? Here are five things to consider when selecting family dental plans or an individual dental insurance plan that works for you!

1. Shop around! Finding a plan that works can be quite a feat. Even when employers offer dental insurance benefits to their employees and their families, it often isn't enough. This means you'll need to shop high and low until you find the best plan for your budget and lifestyle. The Internet has made all of this much easier - you have access to informational materials on a multitude of companies right at your finger tips. Be sure to read all the fine print; when it comes to your health, surprises are rarely a good thing.
2. Know your limits. All insurance plans have maximums - some good, others bad. A low maximum on your total benefits is never a good thing. That means if something major (and expensive) comes up, you may have to delve into your own pockets. A second maximum applies to your yearly deductible, which is the most amount of money you'd be expected to pay for your own care. A low maximum on your deductible is a great thing, so be sure to do the math when comparing policies.
3. Maintain control over your health. A dental insurance company may or may not have your best interests at heart, but, either way, they're somewhat removed from the situation. It's important that you have a say in your dental health. For starters, shouldn't you be able to choose your dentist, or at least have a plethora of options should one provider not work out? It's also important that you and your dentist have a lot of pull when it comes to making important decisions - an insurance company should never put unreasonable restrictions on the type of care you can receive.
4. Look for the 3 R's (sort of): PRevention, Restoration and EmeRgency Care. Having access to these three types of dental care is critical for lifelong oral health. Preventive care reduces the likelihood that you'll develop a dental condition that could have been avoided. Restorative care ensures that things that do go wrong, such as damaged or decayed teeth, will be fixed. Finally, emergency care you'll receive the proper care when you need it immediately, such as if your tooth is knocked out. Some family dental plans cover other specialty care, like orthodontics, so consider your needs and go from there.
5. The waiting game. Some insurance companies make you wait a certain period of time before they will cover certain procedures. If you need immediate attention, find a policy that supports it. If everything's in order, however, a minor wait may not be a major issue for you.

A carefully selected family or individual dental insurance plan could not only save you in a pinch, but ensure good oral health for life. It's critical, however, to do your research and read the fine print. Don't let your dental insurance company take you for a ride!

+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.