Learning About Types Of Dental Insurance
Dental Insurance has been around thirty years. The original plans were known as Indemnity insurance plans. These plans were called 80/20 plan. The insurance paid 80% of the bill no matter what it was for, and the patient paid 20%. Premiums were quite high, but there were many advantages. You could go to a dentist who has the insurance and you do not need permission or referrals from the insurance company to change dentists.
The entire insurance industry has made some major changes over the years, and one has to turn away from the dental insurance standard indemnity plans for the now familiar HMO and PPO plans. Many patients do not even realize that there is a difference between the two until they try to get an appointment with a dentist and the new problems.
Dental HMOs work like medical care organizations - you need to stay in the network and you have a referral for specialized care, including endodontics, orthodontics, etc. PPOs, again, work on the same principle as medical insurance, PPOs, where you can go for a dentist you want for any reason, regardless of location, network, specialty, etc., as long as he takes insurance.
In both cases, other plans obviously have different coverages. A few offer free routine care such as cleaning twice a year and annual xrays. These usually require a nominal co-payment from $ 5 to $ 15 per visit. Some plans offer a higher guarantees for issues such as extraction, root canals or caps, but it does not really matter if an HMO or a PPO. When it comes to what is paid, the type of insurance has little impact on what is covered and what not.
Some of the older plans have waiting periods for pre-existing conditions. For example, if you knew you needed a root canal, you could not walk to buy insurance and make an immediate appointment for the procedure. You probably need to wait six months or so. Today, this pre-existing condition clause is all but restricted to regular medical insurance. With dental plans, it is rarely seen or in effect any more.
Along with dental insurance, there are other options that are nearly identical, and in some cases even better. These are the "discount" plans. Run almost like an insurance program, the patient buys a plan that fits his needs, and they vary widely. There are family plans and individual plans and plans that many cosmetic dental procedures such as bleaching and implants covered. When you are covered with one of these discount plans, there is a fixed amount that your dentist has agreed, along with a standard co-pay of about $ 10 or so.
The only difference between these plans and discount dental insurance plan is that all you need to pay for a procedure (eg a cap or root canal) has been given the dentist. There is no additional benefit of an insurance company.
Many people buy one of these discount plans to use in addition to their regular insurance sometimes just to get their teeth bleached or veneers that get covered.