What is Dental Plans? And How It’s Different From Dental Insurance

What is Dental Plans? And How It’s Different From Dental Insurance

Most people get their dental coverage through work. Dental plans, on the other hand, are available for the people that do not receive dental benefits through their work or business. Dental plans are affordable to join and are the most widely available dental programs for individuals and families. Because most dental disease is preventable, dental plans are structured to encourage patients to get regular, routine care so vital to preventing and diagnosing the onset of serious disease.

Dental plans help people who don’t get the dental coverage from their workplace, in paying for dental care. Good dental care is your right, and can best be attained by understanding your specific dental needs and how your dental plan relates to them.

Types of Dental Plans

1) Indemnity Plans: Indemnity benefits are expressed as a traditional covered fee-for-service. They are slightly more expensive but they give people the freedom of choice of receiving aid from the dentist they want. Limits and co-payments are set according to the level of coverage purchased by the employer or union. Normally, the employee pays a monthly premium to the insurance company, which covers a portion of his or her dental expenses. Most indemnity plans limit the annual dollar amount on benefits, however, and may apply probationary periods on procedures that could last up to a year. The average monthly cost of an indemnity plan is between $19 and $25.

2) Direct Reimbursement Plans: A direct reimbursement plan is a self-funded benefit plan and is not considered an insurance plan. It enables employers to offer cost-effective dental benefits while allowing employees the freedom to choose their own dentists. The patient receives prescribed dental treatment and is reimbursed directly by the employer. Typically, there are no monthly premiums. The patient pays the full amount to the dentist, gets a receipt for the employer, who reimburses them for part or all of the dental costs, depending upon the patients specific benefits.

3) Preferred Provider Organization (PPO): Preferred Provider Organizations (PPOs) are somewhere between an indemnity plan and a dental HMO. In this plan, a group of dentists who contract with an insurance company,  provide care at discounted fees. If you go to a dentist in the network you’ll pay one set of prices. Or you can take a lower reimbursement percentage to see a dentist who is not in the plan. But if you do, you will pay higher deductibles and co-payments. Typically, PPOs have monthly premiums and may have an annual dollar cap. The average monthly cost is $20.

4) Dental Health Management Organization (DHMO): Similar to a traditional HMO & also known as capitation plans. You’re assigned to a specific dental office where contracting dentists receive a fixed monthly fee per patient regardless of whether treatment is performed. This type of plan offers the best deal in terms of limiting out-of-pocket costs. Premium costs are also likely to be the most affordable. The average premium for single coverage: $13 per month. Patients may be referred to a specialist who also contracts with the plan, but they must pay in full if they use a dentist outside of the network. They are normally characterized by monthly premiums.

5) Discount Dental Plans/Referral Plans: Discount dental plans, or referral plans, are the most widely available to individuals. Participants of these plans must use a participating dentist, who has agreed to offer services at a discounted rate. Typically, you pay an initial enrollment fee as well as a monthly fee to the discount company through which your discount is secured. The average monthly cost is $7 to $20.

Everyone want to opt for the best dental plan, Although there is no one “best” dental plan, some plans will be better than others for you and your family’s dental needs. Plans will primarily differ in how much you have to pay. Although no plan will pay for all the costs associated with your dental care, some plans will cover more than others.

With any dental plan, you will pay a basic premium, usually monthly, to buy the dental insurance coverage. In addition, there are often other payments you must make. These payments will vary by plan but essentially are deductibles, co-payments, and coinsurance.

Difference Between Dental Insurance & Dental Plan

Maintaining good oral health i.e. taking care of your denture & correcting dental problems is essential to a healthy lifestyle. But dental care is so expensive, that most people can’t afford it. Dental insurance is one solution for that. Don’t wait until you already have problems with your teeth to get dental insurance, Instead, you should get dental insurance as soon as you can.

Dental insurance is becoming a necessity in everyday life due to the increased costs of visiting the dentist. Dental insurance may be less effective than dental plans, but it is usually offered free.

Dental Insurance: Dental insurance not only covers the things that can go wrong with your teeth but it will also cover the costs of bi-yearly check-ups to make sure that your teeth are still strong and healthy.

Dental insurance is slightly different than most dental plans since you will have to get it through your employer. Dental insurance is not usually offered to individuals and is instead offered to major companies. Dental insurance is utilized by large groups and businesses to cover their employee’s dental care. Dental insurance requires paying monthly premiums for defined coverage. Dental insurance is not readily accessible to individuals and families unless provided by their employer. If you are offered this insurance through your employer, then you should take it since it will be either free or very cheap.

Disadvantages: There are some disadvantages to dental insurance:

  • It is not generally available to regular people unless they can get it through their employers.
  • Some drawbacks of dental insurance include annual spending maximums, deductibles, waiting periods for certain procedures, and limitations and exclusions on care.
  • This insurance will not cover all types of dental work, and it also usually has a spending limit per year. Therefore, if you do not already have dental insurance through your job, then you should look for a different type of dental plan.
  • There are also tedious claims forms to fill out and submit.
  • Dental insurance usually covers the cost of preventive services (such as cleanings and exams) only after deductibles are met.

Dental Plans: Most people who cannot afford dental insurance get involved with dental plans, some of which are quite cheap. These plans also tend to cover part of your dental costs, instead of all of them. Therefore, these plans are less like insurance and more as though you are just getting a discount on your dental work, sometimes called “discount dental plans”. Discount dental plans are designed to provide consumers access to dental networks at reduced rates. These plans, are commonly known as “referral” or “reduced fee” plans and are not considered an insured dental plan.

These discount plans work differently than dental insurance plans, yet provide consumers with real and substantial savings on most dental procedures. Discount dental plans are membership-based programs that usually provide coverage on an annual basis. Consumers pay a membership fee in exchange for secured discounts on most dental services, such as dental exams, routine cleanings, fillings, extractions, root canals, dentures, crowns, and braces.

Conclusion: In any case, dental insurance is a great deal if you can get it for free through your employer, though it is not a very good purchase to make on your own. Also, before buying any dental insurance, make sure that you find out how much and what is covered by the plan. While there are several differences between traditional dental insurance plans and discount dental plans, they can also be used together in certain situations to maximize savings.

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