View Single Post
  #2 (permalink)  
Old 03-05-2004, 08:49 PM
Lifestar's Avatar
Lifestar Lifestar is offline
Nine Year Member
FamilyCorner Junkie
 
Join Date: Apr 2002
Location: I'm in a New York State of Mind
Posts: 1,823
The National Association of Dental Practitioners Defines different Dental insurance coverages as follows:

TYPES OF DENTAL INSURANCE PLANS PLANS: To minimize frustrations with dental benefits, consumers should educate themselves on their choices in dental
benefits—especially when an employer offers a choice in the type of plan. The most common types of dental benefit offerings include:

HMO

Dental HMOs provide services
through a network of dentists who
are paid per enrollee on a monthly
basis.
• Lowest premium for an insured
benefit plan and low.
• Predictable out-of-pocket
expenses.
There is also usually no annual
maximum benefit.
• Smallest network of dentists
(NOTE: Dentists must have a large
enough population of enrollees to
provide the pool of funds needed to
support services on a per capita basis.)
• No coverage if a dentist is not in
the network.

Dental PPO

Dental PPOs provide services
through a network of dentists on a
discounted fee-for-service basis.
• Larger network of dentists
• Scheduled out-of-pocket costs
although at a higher rate than
dental HMOs.
• Some level of payment when a
dentist that is not in the network
is used.
• Medium high premium and copayment
levels.

Dental Indemnity

Dental indemnity plans reimburse for
services from any dentist on a feefor-
service basis.
• No network of dentists allows
consumer to use any licenses
dentist.
• Highest premium and copayment
levels.

Dental Referral or Access Plan

Dental referral or access plans
provide access to a network of
providers at discounted rates.
• Leading benefit purchased by
individuals.
• Provides some discount from
dentist’s regular charges.
• Services must be obtained in
network.
• Services are paid for by the
consumer at the discounted rate.
• This is not insurance but an
access benefit


As far as Dental Discount Programs they offer this comparrison and advise on their website www.nadp.com :


Dental Insurance vs. Discount Plans

Some consumers are confused by the differences between dental insurance and dental "discount" plans. Dental insurance is true insurance. You pay regular premiums for your coverage and your plan has annual spending caps. It generally covers 100 percent of the cost of preventive services after you meet your deductible.

Dental discount plans are not insurance and they work differently. These are membership-based programs. In exchange for a fee, members get discounts on a variety of dental services, such as fillings, braces, exams, and routine cleanings. Members typically receive about 30 percent off standard out-of-pocket prices. The are akin to "diner's clubs," in which you buy a book of coupons and get a percentage off of your meals at participating restaurants.

With a dental discount plan, you must go to a dentist who has agreed to participate in the plan and offer services at a discounted price — say $650 for a crown instead of the standard rate of $750.

Some typical features of these plans:

An initial enrollment fee.
A monthly fee to the dental-discount company.
Discounts on cosmetic procedures that are excluded from most dental insurance plans.

Be aware that dental discounts plans are not regulated by state insurance departments. That doesn't mean these plans aren't legitimate, but you should take precautions when buying a dental discount plan, especially over the Internet, where you have to provide a variety of confidential information.

According to the NADP, these are some questions you should always ask a dental insurance or discount plan:

Are you licensed to offer this plan in this state? True dental insurers must be licensed in your state to sell dental insurance.

Are you registered with the Secretary of State? All legitimate companies operating in a state should have at least filed documents with the Secretary of State in the state where they are operating.

Are you registered with the Better Business Bureau? The BBB maintains a large database of companies, where they operate, contact information, and complaint data.

Where are you located and what is your address of operations? A bogus dental plan is likely to be hesitant to give you this information or will give you an address that is nothing more than a local post office box.

Can you mail me specifics on the plan before I sign up with the plan? Fraudulent plans are more likely to collect your "membership fee" before they will send you any information. All legitimate plans will have marketing materials that they will be more than happy to send you.

Do you have a Web site with more information? Most legitimate dental plan companies have extensive Web sites that outline their plan benefits, approximate costs, and the providers accepting the plan in your area.

Can I get a list of providers on the plan? Avoid any plan that cannot provide you with a list of dentists who accept their plan.

Can I think about it and get back to you next week? Bogus plans use high-pressure techniques to get you to join the day you call.

Is your plan endorsed by or affiliated with a legitimate national organization? According to the NADP, a recent bogus dental plan said it was endorsed by the "United Dental Association." There is no such organization.




Val


__________________
Reply With Quote