(Part 2 of 3)

 Important factors while finalizing on a Dental Insurance Plan

An employee has to ask himself the following before he finalizes on a plan:

Would the employees like to retain the freedom of choosing their own dentists?

Will the mode of treatment be determined by the patient and the dentist?

What type of routine and preventive dental care is covered? Does the plan cover braces, oral surgery, crowns and bridges, root canals and treatment of periodontal diseases?

Will the plan cover all diagnostic, preventive and emergency services? Including preventive services viz. sealants & fluoride treatments, which might result in financial savings to the patient in future? Does it provide for full-mouth x-rays?

What forms of major dental care is covered? Does the plan cover implants, dentures, or treatment for temporomandibular disorders?

Does the plan allow for specialist referrals? If so, has the dentist be limited to “the” list of specialists to choose form?

Does the plan provide for emergencies? What are the provisions made for emergency care when the patient is on tour?

What percentage of monthly premiums goes into actual care and not to administration?

Dental Insurance benefit coverage should be taken into consideration but should not be the deciding factor in choosing the treatment.

Dental Insurance Plan Models

There are numerous dental plans available. Basically they are of two kinds:

Managed care and Fee-for-service.

Managed care dental plans are restricted forms of dental insurance which aim at reducing costs and payouts. They tend to restrict the coverage by limiting the access to care by restrictions (by predefining dentist, specialist, hospital or treatments in form of lists) and restricting level, type and frequency of treatment (usually in form of clauses in the coverage policy).

Fee-for-service dental plans have a freedom of choice options where one can choose their own dentist and the fee is paid as fixed by the dentist. ……..(Go To Part 3)

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