Having a healthy smile can mean having good overall health. Periodic visits to your dentist help keep your mouth and teeth healthy. Dental problems can lead to other health issues. Many people are quite surprised to learn that some forms of heart disease and even diabetes are directly associated with gum disease. Keeping a healthy smile means seeing the dentist regularly, and that costs money. One way to fund these costs is to buy dental insurance.
The Three Types of Dental Insurance
Health insurance is a way for a group of people with a common aim to fund the high cost of medical care. Dental insurance is a special type of health insurance that limits coverage to just dental and oral health care costs only. True dental insurance or “indemnity” is one category of dental insurance that allows the insured to see any dentist that will accept insurance company payments. Another category of insurance that is important to know about is part of the HMO family of insurance products. These are DHMO’s or Dental Health Managed Organizations. This form of dental insurance differs from indemnity in that the insured is assigned to a network that includes a group of dental practitioners, and the insured must use one of the providers in that network in order to be eligible for benefits. A third form of dental coverage is known as “Preferred Provider Network” (PPO) which is an organization that consists of dental health care providers that have entered into an agreement with a third-party insurance provider to provide dental care at discounted rates.
The Origin of Dental Insurance Plans
It is very common for dentists to maintain a fee schedule for services in order to maintain a degree of consistency within their internal billing system. Dental insurance providers maintain their own schedules. When a participating dentist enters into an agreement with an insurance company to join their network, the two fee schedules are reconciled or matched up so that the patients can receive care at a reduced rate, and the dentist can obtain the closest thing to a regular and predictable income in exchange for their participation in the plan.
When you enroll in a DHMO plan, you will need to use a dentist that is a participating provider of that plan. If you use a dentist that is out of network, you are subject to out of pocket expenses related to any differences between what your dentist bills you and what is called for in the fee schedule as per the plan you have joined. Be advised that some dental plans have a waiting period, which is a period of time that must elapse before some services can be covered. These waiting periods most often apply to new enrollees.
Limits on Coverage
Almost every dental plan will feature a maximum limit on the annual benefits the insurer will pay out. When the maximum limit is reached the cost of any additional work you have performed will likely become your responsibility. At the beginning of a new year, your annual maximum will be reissued. If you belong to a plan with an annual limit, it is important to discuss with your dentist the planning and scheduling of any work needed so you can conform to your plan’s requirements. To do this effectively, you need to be aware of what the actual reissue date. This information should be clearly spelled out in your policy.
Lisa Collins a well known writer has been writing numerous articles on health insurance. for more information on different health insurances visit the website Dentalinsurance.net