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.
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
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.
|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 those thinking of offering DENTAL INSURANCE|
|CONSUMER DENTAL HEALTH CARE INFORMATION||INFORMATION FOR DENTAL HEALTH CARE PROFESSIONALS|
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