Dental Insurance, Who Knew? Part 2
One of the questions in my first post about dental insurance that I think is critical when you are choosing a dental plan is:
Where can I receive treatment?
Some dental plans are called traditional or indemnity plans. This means you can see any dentist you like in any location. You may have less out-of-pocket expense if you see a dentist in their network or a “preferred provider”, but it is not a requirement of the policy in order for you to receive benefits.
A PPO plan is another type. This is where it gets a little tricky. Some PPO plans still allow you to choose any dentist you like, but will pay benefits at a lesser rate or based on a fee schedule. Other PPO plans require that you see a dentist that is part of their network. In most cases you can check with your dental office or even better check the insurance company’s website for the most current listing of network providers or participating dentists.
BEWARE: accepting insurance is different than being a participating provider with a particular company. The difference can cost you $$$$.
Usually one of the most cost effective type plans for both employees and employers is called a capitation dental plan. A lot of times this is a very attractive policy because you may have little to no out-of-pocket-expenses. But you can only see a participating dentist or dental facility. Often times, you are required to pick a dentist or office when you sign up without knowing anything about them. For some people, this is okay. Other people, like me, are dentally challenged or just plain scared. So, I need to know who is sticking their fingers in my mouth.
Lastly, there are some dental discount programs. Typically these are not offered by employers. Usually these are aimed at individuals and again require you to see a participating provider. The participating provider agrees to provide care to you based on the company’s fee schedule. In other words, if the dentist charges $140 for an extraction and the fee schedule allows $100, you pay $100 and receive a discount of $40.
Dr. John Artemenko, Sterling Heights MI
Do you have a question about dental insurance? Please call me (586)939-8800 or email insurance@drjeart.com.
