Choosing A Dental Plan

Many people face a dilemma when it is time to choose dental insurance. Does a person go with one of the plans in the packet the human resources manager hands you after working long enough for the company? Is the health marketplace a better option for your situation?

Types of Dental Plans

You are likely to see the abbreviations PPO and HMO during your dental coverage search. Perhaps you will see commercials for dental rebates or markdown plans. Another type of insurance you may not be familiar with is dental indemnities. Web MD points out the things dental patients need to know about each insurance type.

Preferred Provider Organizations

A PPO is similar to HMOs where you have a network or group of dentists you can compare and select. With this insurance type, you will pay more out-of-pocket each week. This extra cost gives members a larger pool of candidates than a health maintenance organization. PPO members can use out-of-network dentists. The difference for these services is that the patient gets some coverage from the preferred network where HMO's cover nothing outside for providers not on the membership list.

Health Maintenance Organizations

HMO's are the most common type of periodontal insurance. These memberships are more affordable for working members, and employers often provide this coverage type for employees. The downfall of this program is how strict the provider is about the network. Any work using a provider, not on the list gets no coverage by the HMO, and the patient must pay 100 percent of the cost of the services.

Indemnity Plans

Indemnity health insurance is a more expensive option giving members more freedom over whom they see for dental work. The members also choose a fixed cost for services that fits their needs making costs easy to manage. These plans often have high deductibles and co-payments due at the time of service. Indemnity insurance does not require participants to choose from a list of dental providers. The family or individual is free to select the periodontist or dentist one wants.

Discount Cards and Memberships

While commercials make these offers sound glamorous, the stark reality is that the plan is not technically dental insurance. These memberships help people reduce the cost of specific procedures like x-rays or tooth extractions. For a small monthly fee, a member may get a reduction for the overall cost of a procedure.

Deductibles

Deductibles are the cost a person must pay before the insurance begins to cover or pay for services. Patients typically have to pay this cost at the beginning of the year. The member pays out-of-pocket for expenses until meeting the deductible. Some plans may not require this fee for preventative work like cleanings and routine exams.

Timelines for Coverage

Does your provider require a waiting period before you can use service? For example, it may be necessary to be a member to wait for two years before getting crowns or dentures. Coverage limitations are common with many popular insurance types. Even when patients wait, the insurance may only pay a portion of the bill.

Individual Coverage vs. Group Insurance

When purchasing anything in bulk, the price is often lower for each portion or sale. Periodontal insurance is the same way. Groups can get a lower personal cost because so many people are signing up to be part of the plan.

Insurance Classes

• First-class - Routine checkups and prevention services
• Second class - Basic dental repairs like fillings
• Third class - In-depth treatment such as root canals and placing crowns
• Fourth class - Orthodontic services for braces and realigning teeth, this coverage may have a separate cap for services or only cover patients to a particular age 

Choosing the right plan for your family might include a combination of health coverage and dental discount memberships. Some coverage types may not extend to your location or have yearly maximum limits.

Dr. Attalla is a leading Periodontist in Nassau County NY. Learn more about her services by visiting NassauCountyPeriodontist.com