Dental

Dental Insurance can improve an employees’ overall health by encouraging frequent preventive care with little or no cost to the employee while also providing coverage with basic and major services.  Studies have shown that a direct link between good dental hygiene and more thank 100 physical and mental ailments including diabetes and heart disease.  Dentist can be at the forefront of catching signs of disease in the very early stages and can refer the patient to a physician that specializes in that discipline.

 

Generally speaking there are three types of dental insurance; Indemnity, PPO and DMO which can be paid for in part or in full by the employer or offered as a voluntary program where the employee pays the full cost of the plan.

 

Indemnity
Least Restrictive, Higher Cost

 

• Flexibility to use any dentist
• Claims are based on Reasonable and Customary Charges
• Can include Orthodontia
• Can apply a waiting period for late entrants
• Usually the most expensive in the absence of a network

 

PPO (Preferred Provider Organization)
Less Restrictions, High Cost

 

• Providing access to network and non-network dentists
• In-Network claims are based on the negotiated fee between the insurance company and the dentist.  The savings are passed on to the patient.
• Out-of-network claims are based on Reasonable and Customary Charges
• Can include Orthodontia
• Can apply a waiting period for late entrants
• Usually more expensive than a DMO but less expensive as an indemnity plan.

 

PPO (Preferred Provider Organization)
More Restrictions, Lower Cost

 

• Providing access to network dentists only.
• May require a referral to see a dental specialist (Periodontist as an example)
• In-Network claims are based on the negotiated fee between the insurance company and the dentist.  The savings are passed on to the patient.
• There is no coverage not Non-Network providers
• Can include Orthodontia
• Can apply a waiting period for late entrants
• Usually, but not always requires minimum participation of typically 20% - 30% of eligible employees.
• Usually less expensive than a PPO and indemnity plans.