Understanding the basics of dental insurance and how it can benefit you.

- Different Dental Insurance Plans for Different Needs: Consumers can choose from an assortment of dental benefits plans that accommodate a variety of needs and expectations. The following factors may influence the type of dental insurance plan you purchase...

- Cleaning Your Teeth:
Replace your toothbrush every three or four months or sooner if the bristles become frayed. A worn toothbrush will not do a good job of cleaning your teeth. Children’s toothbrushes often need replacing more frequently than adults because they can wear out sooner...

- Dental Sealants:
 Dental sealants act as a barrier, protecting the teeth against decay-causing bacteria. The sealants are usually applied to the chewing surfaces of the back teeth (premolars and molars) where decay occurs most often...

 - Dentures:
If you’ve lost all of your natural teeth, whether from periodontal disease, tooth decay or injury, complete dentures can replace your missing teeth and your smile. Replacing missing teeth will benefit your appearance and your health...

- Dental Health:
 Based on information gathered during the 2001 American Dental Association (ADA) annual session, dentists report that oral bacteria, in some studies, have been associated with heart disease, stroke, diabetes and the birth of pre-term, low- birth- weight babies...

- Wisdom Teeth:
 Wisdom teeth are a valuable asset to the mouth when they are healthy and properly positioned. Often, however, problems develop that require their removal. When the jaw isn't large enough to accommodate wisdom teeth...

- Tooth Decay:
Although tooth decay has declined among young children as a group, it can still be a problem for individual children, and even teens and adults...

- Making Informed Choices:
 The law mandates that consumers with dental coverage receive a fully detailed patient information handbook -- a Description of Benefits -- that clearly outlines coverage, limitations and exclusions...

- Choosing a Dentist: Dental benefits plans can be categorized by the options offered for selecting a dentist. Some plans allow you the freedom to choose your own dentist...

- Paying the Dentist: When choosing a benefits plan, it is important to know who pays what to whom. Dental plans can be categorized into three types based on the compensation and treatment provided...

- All Dental Plans have their Limitations:
Today's health insurance, including your dental plan, is designed to help you get the care you need at a reasonable cost. Because each person's oral health is different, costs can vary widely. To control dental treatment costs...

- Annual Benefits:
To help contain costs, your plan may limit your benefits by number of procedures and/or dollar amount in a given year. In most cases, particularly if you've been getting regular preventive care, these limitations allow for adequate coverage...

- Getting the Most out of Your Dental Plan:
 To take full advantage of your dental benefits plan, visit the dentist regularly and get the preventive care that will keep your mouth healthy...


Find the right dental insurance plan for you. Insurance company offers traditional fee-for-service, dental PPO and prepaid program options for individuals and families looking for dental insurance.
 
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Finding the right value in individual dental insurance and family dental insurance is an important step in purchasing affordable dental insurance health care coverage. Both types of dental plans (dental insurance and discount dental plans) have advantages and disadvantages and one size does not fit everyone. We sell both individual and family dental insurance and dental discount plans throughout all 50 states.

Dental Insurance

The dental insurance programs listed are based upon the zip code you enter and their availability. If we are unable to offer a dental insurance plan, we will provide a alternative dental plan, if available, and clearly state it. Please be sure to contact the plan dental office to confirm they are accepting new patients and they are accepting the dental plan you have selected.

If you have any dental insurance plan questions please feel free to contact our office during regular business hours. You will find our licensed insurance agents ready to assist you.

Our dental web site is very clear if you are selecting a dental insurance plan or a dental discount plan. We understand that there are many dental plan web sites popping-up all over the internet, claiming to offer "dental insurance" when in fact they do not and are not licensed to offer a dental insurance plan.

If you find a site that says they offer dental insurance, they are "required" to show their insurance license information on the web site, as noted at the bottom of this page. If they don't, then report them to your local state department of insurance. If you find a dental web site stating they offer "dental insurance" and in fact they don't, then take the opportunity to report that site to the search engine you found them on.
 

Our entire staff is licensed to offer, sell and service dental insurance. Always ask to speak with a licensed insurance agent. Ask them if they are licensed. Full disclosure is our guarantee...

 

Dental Insurance Indemnity Plans

This type of dental plan pays the dental office (dentist) on a traditional fee-for-service basis. A monthly premium is paid by the client and/or the employer to an insurance company, which then reimburses the dental office (dentist) for the services rendered. An insurance company usually pays between 50% - 80% of the dental office (dentist) fees for a covered procedures; the remaining 20% - 50% is paid by the client. These plans often have a pre-determined or set deductible amount which varies from plan to plan. Indemnity plans also can limit the amount of services covered within a given year and pay the dentist based on a variety of fee schedules. Some typical features of these plans:

  • High deductibles before coverage begins (well-designed plans don't apply the deductible to preventive services)

  • Probationary periods on certain procedures that last up to a year

  • Annual dollar limit on benefits

  • Chose your own dentist

  • Your average monthly cost: $15 to $25

  • Companies selling these plans are regulated by state insurance departments.

Dental Insurance HMOs

These insurance plans, also known as "capitation plans," operate like their medical HMO cousins. This type of dental plan provides a comprehensive dental care to enrolled patients through designated provider office (dentist). A Dental Health Maintenance Organization (DHMO) is a common example of a capitation plan. The dentist is paid on a per capita (per person) basis rather than for actual treatment provided. Participating dentists receive a fixes monthly fee based on the number of patients assigned to the office. In addition to premiums, client co-payments may be required for each visit. Some typical features of these plans:

  • Monthly premiums (some require you to prepay a year's worth)

  • Co-payments for office visits

  • Free preventive or routine care

  • You must select from an approved network of dentists

  • May have an initial enrollment fee

  • Annual dollar cap

  • Your average monthly cost: $5 to $15

  • Companies selling these plans are regulated by state insurance departments.

Dental Preferred Provider Organizations

Another true insurance plan, a Preferred provider organizations ( PPO) falls somewhere between an indemnity plan and a dental HMO. This plan allows a particular group of patients to receive dental care from a defined panel of dentists. The participating dentist agrees to charge less than usual fees to this specific patient base, providing savings for the plan purchaser. If the patient chooses to see a dentist who is not designated as a "preferred provider," that patient may be required to pay a greater share of the fee-for-service.  A group of dentists agrees to provide services at a deeply discounted rate, giving you substantial savings — as long as you stay in their network. Unlike the more restrictive DHMO, though, you can go out of network and still receive some benefits. Some typical features of these plans:

  • Monthly premiums

  • Annual dollar cap

  • You must stay within the approved network of dentists or pay higher deductibles and co-payments

  • Your average monthly cost: $20-25

  • Companies selling these plans are regulated by state insurance departments.

Dental Discount Plan

This type of dental plan is not insurance. The managing organizations have negotiated with local dental offices to establish a set price for a particular dental procedure and offer deep discounts (some from 20-60%) off the regular ADA pricing code. This plan has several advantages over traditional dental insurance plans. This allows a patient to receive immediate service for work without any waiting requirements and no limits on use.

Dental Direct Reimbursement Plans

A dental care plan now coming into vogue is the direct reimbursement plan. This is a self-funded benefit plan — not insurance — in which an employer pays for dental care with its own funds, rather than paying premiums to an insurance company or third-party administrator. You, the patient, pay the full amount directly to the dentist, then get a receipt detailing services rendered and the cost, which you show to your employer. The employer reimburses you for part or all of the dental costs, depending on your specific benefits.

Your company might reimburse 100 percent of your first $100 of dental expenses and then 80 percent of the next $500, and 50 percent of the next $2,000, with a total annual maximum benefit of $1,500. Or it might reimburse only 50 percent of your first $1,000, resulting in a $500 yearly cap.
Some typical features of a direct reimbursement plan:

    Some typical features of a direct reimbursement plan:

  • Neither you nor your employer pay monthly premiums

  • Freedom to choose any dentist

  • Typical employer cost: depends on the number of employees and

  • benefit caps

  • Benefits usually capped at $500 to $2,000 annually.

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2009-07-02T10:08:25+00:00 Reviewed. Harbor City - Los Angeles, California.