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AK Dental Arts Dentistry Blog

Dental Insurance Plans – Help in Choosing

Let us help in your evaluation of dental insurance plans.

Health care insurance has changed. You already know that. But how much time do you spend evaluating dental insurance plans? How do you compare one plan to another? Most people, given a selection, will choose the cheapest option – and then find out later that this decision was a mistake.

Getting Coverage through Private Insurance or through the Exchange

If you are purchasing dental coverage through the public Exchange on HealthCare.gov or through a private insurance company, you need to take the same care as those with employer-sponsored dental care.  Without understanding the different options, you may think you are getting great dental insurance, but you may not be.  Some plans, especially low-cost options offer minimal coverage, limit treatment options, and restrict you to particular dental providers. Be sure you understand the benefits and limitations of these plans.

Employer-Sponsored Dental Insurance Plans

Your selection of dental plans is usually presented by your employer in October or November of the prior year. You may have a selection of your deductible and co-payment, which is the percentage of the procedure you will be responsible for. This selection will determine your total out of pocket costs. So spending some time with your spouse and selecting the best plan for you is very important. Your dental office should help you in your decision since your benefits are well understood by the office staff.

Taking Care Now Avoids Pain Later

We are shocked by the number of patients who are unaware of the importance of this decision.  When asked why they didn’t contact our office or help, their answer mostly is ” I should have.”

DMO vs. PPO Dental Insurance Plans – what’s the difference?

If you have the option of obtaining dental insurance from your employer, you may be offered the selection of a DMO ( Dental Maintenance Organization) or a PPO (preferred Provider Organization. You may be confused about the differences. If you have the option, most times the PPO is the better choice. Why? It is less restrictive. It allows you your choice of dentists. It allows payment for more procedures. It doesn’t restrict referral to a specialist. With a DMO, you may be restricted to using dentists you do not know and who do not know you. The DMO office makes its income by volume, not by perfection. It is better for the DMO office if you don’t come for that maintenance visit, since they get paid per month whether you come or not. That’s why it’s a cheaper plan. If you choose a DMO, which appears a less costly option, you will be stuck with this for the rest of the calendar year, whether it suits your needs or not.

Dental Insurance Plans May Not Let You Choose Your Dentist

Did you know that your dental plan may limit the dentist you can visit to care for your mouth?  All dentists are not alike. They all have a diploma, but that is where the similarity stops.

  • The commitment to continuing education is different.
  • The purchasing of supplies that are more beneficial for the patient care and success are different.
  • The techniques for providing services are different.
  • The discerning ways of giving the best service are different.
  • When one dentist “accepts” a questionable impression for a crown or denture (it’s good enough), another throws it out and redoes it, knowing the better impression will provide lasting comfort and usefulness to the patient.
  • The thought processes of all dentists are not the same, resulting in different treatment plans and outcomes.

Importance of your Dentist’s Philosophy of Care

What does being a dentist mean to me?  It means really knowing you and your health. It means constantly doing my best to get the job done the best way possible. It means willing to redo a procedure when I can make it better. It means communicating with you for an understanding of costs and procedures. It means caring about the outcome and follow up to ensure success.

Importance of Continuity of Care

Selecting a dentist on a limited insurance list of providers does not guarantee the best care for you. It also may mean seeing one of several practitioners within that practice whom you did not expect or want to see. Maybe the dentist you see today won’t even be there next time you’re there for your visit. Continuity of care is very important in healthcare. This is an important factor that patients overlook, jumping from dentist to dentist as their plans change. You want your doctor to really know you and continue to make decisions for you based upon his prior history and experience with your health. Going from one provider to another every year, based on insurance, does not allow for the continuation and recognition of prior care to determine future decisions for best outcome.

In summary, your decision about your dental care plan should carefully researched and evaluated to be sure it fits your needs. You should make sure your plan will cover you for your personal selection of dentist, and not dictate your choice of dentist.

Have a question about your dental insurance plan?  Need help selecting the plan that fits you best?  Call us at 718-448-3366.