Individual Dental Plans

Other than medical insurance, having a dental plan is one of the most significant factors that will affect your overall health and lifestyle. If you don’t take proper care of your teeth or maintain proper dental hygiene, the risks associated with your oral health increase. In the long term, you’ll end up paying more money reversing damages that could have been prevented. Regular visits for cleaning and check-ups can prevent the onset of serious oral diseases later in life. Assessing and diagnosing problems early on can become costly as well, but not nearly as much as they will become if you don’t take care of them immediately.

There is a difference between “dental insurance” and a “dental plan”. When it comes to dental insurance, the insurance carrier assumes a certain risk, namely the amount of dental assistance that you will need. A dental plan is different in that no third party assumes a risk. Dental plans are not insurance policies.

It is important for you to consider the differences between dental insurance versus a dental plan in order to determine which type of coverage is best for you. With dental insurance you will likely end up paying more for the coverage but less when you obtain covered services. Conversely, with a dental plan you will likely pay less to participate in the dental plan but end up paying more for the actual services that the plan may offer. For purposes of this discussion we will simply refer to both dental insurance and dental plans as “dental plans”.

Some common types of dental plans are as follows:

• Dental Health Maintenance Organization (DHMO)
  Typically, a DHMO is the least expensive of dental (insurance) plans. All dental services are provided by dentists who agree to provide specific treatments and services to patients at no charge, or for a specified co-pay. As in the case of a medical HMO, dentists are paid directly by an insurance company for each individual, regardless of how much or how often covered services are provided. DHMO’s are insured plans. They provide you dental services through a network of providers. If you use a dentist outside of the network there is no coverage payable under this type of plan.
  
• Preferred Provider Organization (PPO)
  A PPO plan provides dental care to its members through a network of dentists who offer discounted cost to its plan members similar to a medical PPO. You can use dentists outside of the network but you will only be reimbursed the discounted cost for the services rendered which means you will responsible for the unpaid balance. Unlike the DHMO, a PPO plan has deductibles and there likely will be waiting periods for certain services. Most of these types of dental insurance plans only pay a set percentage of the charges leaving you to pay the balance due. There is also a maximum amount the insurance will pay annually.
  
• Scheduled Dental Plan
  A scheduled plan or scheduled reimbursement plan reimburses you for a specific amount based on a fee schedule with any balance due being your responsibility. Scheduled plans are not insurance plans. Scheduled plans can include a calendar year maximum, a deductible and have waiting periods on certain procedures. A scheduled plan shows every covered procedure and the amount you have to pay or the amount you will be reimbursed for each procedure.
  
• Discount Plans
  Discount plans and discount cards are offered as a way to lower the cost of dental care. These plans (or cards) are especially attractive for people who do not have insurance coverage or who have inadequate insurance coverage. Discount plans allow for unlimited use of services by using a dental network (usually quite limited) and are based on a discounted fee schedule. The cost of these plans is small compared to the potential savings. These are not insurance plans.
  
• How Do I Decide Which Policy Is Best For Me?
  Selecting the right dental plan for yourself or your family depends largely on your particular circumstances. Because of the variety of available plans and cost differences we recommend you contact us and have a well-qualified, experienced agent review your needs and assist you in obtaining the plan that fits your budget and provides the dental care you actually need.
  

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