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  • Dental Plans & Insurance


    Oral health plays a vital part in the overall confidence of a person in performing his/her tasks on a daily basis. A compromised smile oftentimes means compromised performance. To boost this, a patient must be aware on how to prevent dental health problems and treating them immediately once they set it. In modernity, the dental products such as dental whitening systems and other dental health platforms using state-of-the-art dental technology are sure lot better than those of the previous decades. Before the 21st century, in particular the 19th century, people had a hard time in extinguishing pain felt from dental problems and maladies.

    Today, we’re very blessed to have such convenient dental products and equipment that contribute to relieving a patient’s pain without much painful procedures. And also today, dental insurance has been introduced to free the patient from huge dental costs. Some few examples of dental insurance companies are: Blue Cross, Denta Dental and a Metlife. It is imperative for one to find the best medical insurance that is widely-accepted by dentists, offers reasonable fees and is widely-recognized by dental insurance accreditors. The dental insurance companies (as mentioned above) are widely recognized and used by most companies for their employees’ dental insurance. By signing up on the newsletter below, you will find detailed information on what dental insurance companies to choose from and what dental coverage they offer, including patient reviews for that particular dental insurance company.

    More Information about Dental Plans & Insurance

    Give me some advice regarding dental insurance coverage

    Most insurance companies give the patient freedom to pay their dentist in full and receive a reimbursement for the costs incurred in the dental procedure their dental bills. But due to the recession, only a select number of dentists nowadays accept deductible and co-payment, making it harder for the patient to choose a dentist. For precautionary purposes, a patient must ask the dentist if the latter accepts dental insurance coverage before proceeding with the dental procedure.

    What if the dental office is on my insurance plan’s “out-of-network” list?

    Some patients forget to ask their dental office if the service that they provide are covered by the list of pre-approved practices listed on the dental plan. Most dental offices, though offering a wide array of dental services, only accept limited dental coverage for their services and in the worst case scenario – they do not accept dental insurance plans whatsoever. Some dental offices only accept a mere coverage offered by a patient’s dental insurance plan, say for example, if the fees incurred amount to $7,000, the dental office accepts only dental coverage that pays for half of that amount (or $3,500); the remaining balance should be paid by the customer in cash or through plastic. To make sure that you will not incur costs you cannot afford to pay, make sure to get information from both the insurance company and more importantly, on the dental office you are engaged in, if they both accept full coverage of each other’s payment plans.

    What is DMO or a DHMO?

    A Dental Maintenance Organization or a DMO is a body specializing in providing dental care from a group of dentists. This body of dentists role is mostly limited to only providing preventive dental services, while ensuring qualified services at 100% subtracted from the co-payment. Completion of claim forms is not required.  The only noticeable downside to a DMO is that they are, at most cases, only limited to performing dental practices being approved by the patient’s dentist before these dental procedures begin. These benefits that these plans hold are likely to be enjoyed by newly-opened dental clinics.

    What are the discrete differences between a DMO and an indemnity dental plan?

    A Dental Maintenance Organization (as mentioned above) limits itself to, at most cases, providing services only in the line of providing only dental care from a network of dentists which is only to be approved in advance by the patient’s dentist before any deal takes place. On the other hand, an indemnity dental plan only lets its members receive dental procedures/consultations from veteran professional dentists. Unlike a DMO, members of an indemnity dental plan are required to pass claim forms with the co-insurance and deductible amounts attached to that form. These are the two most preferred dental benefits plan in the industry. But these various plans differ in a lot ways, especially with the variety of procedures offered (wherein a DMO is only limited only to dental care) and the most common cases of the plans are listed below:

    Direct Reimbursement Programs:

    This plans offers a partial or full reimbursement for any dental fees incurred by the patient, regardless of the procedure performed on him/her (still, there are limitations that apply). This plan is mostly accepted by patients with severe dental problems who need a specialized dental procedure to be done on them.

    “Usual, Customary and Reasonable” (UCR) programs:

    This dental plan (like the first one) also allows patients to go the dentist of their choice. However, there is a small provision applied: this plan is designed to pay only a certain proportion of the dentist’s payments or the plan administrator’s fee limit, whichever is lesser of the two options. This plan must be agreed by the three parties (patient, insurance provider & the dentist/dental office). Though being a common choice for most patients, this is still a subject of abuse from few dentists. The lack of government supervision on so-called “customary” fees can be used by the dentist to his/her advantage.

    Preferred Provider Organization (PPO):

    These plans are intended for dentists who look forward to patients who want to have a procedure done on them, and selecting the dentist to do it, hence “preferred”. This relieves a percentage of the amount paid by the patient. This is also useful for a dentist who finds it hard to cope with the competition faced from other dentists in his/her vicinity.

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