While getting health insurance, many of us seek only for covering the costs of treatment for serious medical conditions or accidents, while ignoring the fact that dental insurance is also as important. Proper dental care plays an important role in your overall good health.
1. Third Parties Dental plan usually involves three parties: you, dentist, and a third party insurance, responsible for funding and management of the plan. If your plan is funded by your employer, then an administrator would be responsible for processing and payment of filed claims.
2. Pick the Dentist you want Dental plans where you get to choose a dentist: There are plans which allow you to choose your own dentist, while there are other less expensive plans which may limit your choice. The two types of plans are called open and closed panel plans.Open Panel: Patient can receive care from any dentist, and also any dentist may accept or refuse to treat patients enrolled in the plan.Closed Panel: Patients can receive care only from dentists who have signed a contract of participation with the third party.
3. Paying the Dentist There are plans where the dentist can be paid in different ways:
Indemnity: Insurance carrier charges a monthly premium from the patient and this money gets directly reimbursed to the dentist for his services. The insurance company will pay between 50 percent and 80 percent of the dentist’s fee while the remaining 20 percent to 50 percent is paid by the patient.
Capitation: Dentist is paid on a per person basis rather than for actual treatment. A Dental Health Maintenance Organization (DHMO) is a common example of a capitation plan.
Direct Reimbursement: This is a self-funded plan where the employer or a company will pay with its own funds, rather than paying premiums to an insurance carrier or third party. The patient pays the dentist directly, and the employer will reimburse the employee a fixed percentage of the dental care costs, once the receipt showing payment and services received is supplied.