Individual Dental Insurance Plans
It’s not always employers who are shopping for dental plans. individuals also search for coverage to take care of themselves and their families. There are a wide variety of individual dental plans out there, which can help you keep your teeth healthy without taking a bite out of your wallet.
An important consideration when considering which dental plan to choose for yourself or your family is understanding what is covered and what isn’t. Dental services can be excluded for a number of reasons. Some plans only cover the least expensive procedure that’s available in order to save money. This may mean that a common procedure like a crown won’t be paid for. Or you may need to submit extra paperwork to get your procedure approved. Plans can also vary over the percentage of costs for certain procedures that are covered. One procedure might receive 100 percent coverage, while another might only be covered for 75 percent or 80 percent of the costs.
You should know how the dental plan is designed. Dental insurance plans that are offered strictly for individuals are often “referral plans” in which a patient pays a monthly fee for dental care. This gives them access to dentists who agree to provide care at a reduced fee. Payment is made directly to the dentist.
If your plan is a Preferred Provider Organization (PPO) it means that the plan contracts with dentists to offer services at a discount. You usually have flexibility to choose a dentist that doesn’t take part in the plan, but you’ll likely have to pay more.
Dental Health Maintenance Organizations or DHMOs require patients to go to specific dentists at specific facilities.
A plan that provides for “direct reimbursement” returns a pre-determined percentage of dental costs to patients. It usually allows patients to go to the dentist of their choice.
“Usual Customary and Reasonable” dental plans also allow patients to choose their own dentists. The plan sets a limit on what percentage of the dentist’s fee will be covered. There can be wide differences in what these plans cover.
Some plans give out lists of services that will list the dollar amount that will be cover. It may not represent the full price the dentist will charge.
There’s a lot to consider for individuals and families looking for dental coverage. Blair Insurance can help you figure out the differences between individual dental plans. Contact us today to get started.