This section on DENTAL INSURANCE is provided to help
you make informed decisions when selecting the dental coverage for either your company,
your family or yourself. It is important to understand the distinction between medical
insurance and dental insurance, as well as between the various dental plans available.
The first important distinction, is to understand that when a dental plan is purchased
by your employer, they are looking at a number of options. Among these include, what
the employee will receive for the money spent, and probably more importantly, what
the plan will cost the company. Not all the plans offered will provide the patient
with the same amount of benefit. For example, some plans do NOT allow you to select
your own dentist, they require you to switch dentists and go to one who has agreed
to work within their plan limitations. In addition, there are frequency limitations,
alternate procedure limitations, exclusions and more.
The California Dental Association recently released an article which explained how
for an employer to provide $1,000 worth of dental benefits for the employee, it would
cost about $1,050 using a Direct Reimbursement Program. Under traditional (UCR) indemnity
dental insurance programs, the costs would go up to around $1,300 and with capitation
programs, it could go as high as $1,500. So why would they buy the more expensive
programs? When they are presented to the employers, they are shown in the reverse
way, since an insurance company is in business to make money, they make more when
they sell a plan that provides less benefit to the dentist and more to the adminstrator
of the program. Unfortunately because of this, Direct Reimbursement Programs are
often the last ones employers are told about. In fact, in an article from the October
5, 1998 ADA News, it stated that only 59% of the decision makers for insurance plans
even knew about DR Plans. We understand that each employer needs to make their own
decision based upon the information they are given and the funds they have available.
We suggest that if you are in a position to influence the choice of plan for your
company, you let the person who is in charge of that read the articles below regarding
Direct Reimbursement and contact the California Dental Association for further information.
We are confident it will save your company money, while allowing the patient to select
the dentist of their choice and have the maximum dental work done for the money spent
by the plan provider.
To
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| Direct Reimbursement Guide
for Smart Companies - Brought to you by the American Dental Association.
Takes you step-by-step how to design and administer a Direct Reimbursement Dental
Plan for your company. Reasearch shows that 40% of the people who have dental insurance
NEVER use the benefit. If you are paying a monthly premium for them, you are wasting
money. Under the D.R. plan, this does not happen. In addition, the dental expenses
are paid with pre-tax dollars and as with most Flexible Spending Accounts (FSA's),
the funds in an FSA do not qualify as income, employers are not responsible for paying
wage-sensitive taxes (i.e., FICA and FUTA) on the amounts set aside. Consumer Guide to Dental Insurance - Describes the difference between medical and dental insurance, briefly describes the differences between Dental Service Corporations providing dental coverage, fee-for-service plans, indemity plans, managed care plans, self-funded plans, closed panel plans, preferred provider organizations (PPO's) and exclusive provider organizations (EPO's), capitation plans, direct reiimbursement plans. It also discusses limitations, exclusions and coordination of benefits. This information is provided by the California Dental Association. |
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| Dental Insurance Facts - This article describes and explains UCR (Usual, Customary and Reasonable) fee schedules, Table of Allowances, tips on how to get the most from your dental plan, as well as a discussion on the different types of dental benefits available. This is from a brochure provided by the California Dental Association. | |
| Dental Insurance Programs and Plans - While we encourage the Direct Reimbrsement Program, any dental plan that encourages the public to receive dental care is supported. | |
| ADA ONLINE information sources for DENTAL INSURANCE | |
| CONSUMER DENTAL HEALTH CARE INFORMATION | INFORMATION FOR DENTAL HEALTH CARE PROFESSIONALS | |
| DENTAL
HEALTH TOPICS HOW TO SELECT A DENTIST DENTISTRY 2000 DENTISTS ASK A DENTIST A QUESTION DENTAL INSURANCE INFO |
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ORGANIZATIONS and SCHOOLS DENTAL JOURNALS and MAGAZINES CONTINUING EDUCATION ONLINE PRACTICE MANAGEMENT RESOURCES |
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