Dental Plans For Individuals What Dental Treatment Is Covered

Dental Plans For Individuals – What Dental Treatment Is Covered?

By: - Health & Fitness - November 28, 2011
dental plans for individuals what dental treatment is covered

If you are looking for dental plans for individuals there will be quite a bit of research in your future. If you are a person who cannot get a dental plan through your employer, you may have to get an individual plan. An individual plan is similar to the same plan you will get through a traditional employer in some cases, or it may be totally different. There are actually four main options when it comes to securing dental plans for individuals and even if you already have insurance, one of these options may be more suitable and help you save money.
The first of the main dental plans for individuals is called a PPO. PPO is short for Preferred Provider Organization and will give you access to specific prices and some discounts when using dentists in a specific network. The dentists themselves will only provide services to those in their specific networks, but if you choose to join a PPO, you can see other dentists outside of the network, but will be paying a higher cost. A PPO generally will have a higher cost when it comes to premiums and deductibles and you will also be restricted to a yearly maximum cost of coverage.  PPO’s are almost always for those under employer plans but there are a handful of companies that offer them for individuals as well.
The second of the main plans for individuals is called a DHMO. DHMO is short for Dental Health Maintenance Organization and gives members access to dentists for a fixed monthly fee, no matter what type of work is needed. Generally in a DHMO, preventative dental treatment is free but you have to go to an assigned dentist. The payment used for a DHMO is known as capitation and dentists will be paid based on the number of patients they see, not the work they perform. Some patients feel when part of an HMO that they are herded through procedures and may not get the treatment they actually need.
The third type of plan that individuals may be interested in for dental treatment is called an indemnity or sometimes a reimbursement plan. This plan will reimburse the patient or provider for the treatment given. When under this type of indemnity plan, you can choose any dentist but you should expect high deductibles as well as limited or small yearly maximums. If the indemnity plan works to reimburse you as the patient, you will have to pay full price at the dental office then submit a claim to the company the indemnity is from. If the plan reimburses the dentist, it will work more like a traditional insurance plan and you will just have to pay a co-pay.
The fourth option you have as an individual who needs some help to pay for dental treatment is a discount plan. This is a plan where you will pay a monthly or yearly fee and get a set percentage off at the dental office of your choice that is a part of the network. The percentage ranges from 20% to 60% in most cases and depends on the plan. Some of them offer 100% off of preventative procedures like cleanings and x-rays.
With any dental insurance choice, you will need to look at all the facts and make sure that the plan you choose fits your needs. For some people, a dental discount plan will be the perfect solution, but for others, they may need a PPO. If your employer doesn’t currently offer dental insurance, you may want to see if you can convince them to add it. The most important thing to remember is that if you really want to save money, you should keep up on your preventative maintenance by getting two cleanings and check-ups per year.