When shopping at local markets, stores offer you many options; sometimes choosing the items you need is simple, however, at times it is really hard.
When shopping for life insurance, the options are not that simple; health insurance plans vary widely between one company and another. When selecting your health insurance, you should know for whom your plan is designed; coverage will vary if the plan is for an individual, a family, or a group.
In the case of Dental Insurance plans, in the United States they are usually divided into 3 groups:
- Indemnity Dental Insurance Plan
- Dental Health Managed Organization (DHMO)
- Participating Provider Network (PPO)
Indemnity Dental Insurance Plan
A dental plan that has several benefits, this type of coverage provides patients the opportunity to stay with their dentist and she/he is not obligated to participate in a dental network. This insurance plan makes each procedure subject to coverage as it is needed and performed. Additional benefits of this type of dental plan include:
- Preventive dental care could be covered by 100%
- Basic or Major dental procedures could be covered by 50%-75% (% cover will vary, check with a representative)
The additional treatment costs that are not covered, the patient will have to pay the difference. Overall, this plan offers patients an “open panel” dentist. Meaning you can select your dentist, have your dental treatments covered and be satisfied with the results.
Dental Health Managed Organization (DHMO)
This dental plan offers you different benefits, compare to an Indemnity Insurance Plan. In this insurance plan, your dentist signs a contract with an insurance company; after the contract is set, both the provider and dentist agree and accept an insurance fee.
Also, the provider accepts the commitment to offer their clients a reduced cost for service as an: In-Network Provider.
Dental HMO insurance plans have little to no waiting periods and cover most major dental works. When patients purchase this plan; they patient is trying to prevent annual fees and defray the high cost dental of dental procedures. In summary, this dental plan offers you:
- The Dentist is paid a fixed amount on a scheduled time
- The Dentist is obligated to provide services and all needed treatments to their patients.
- The insurance provider makes a contract with the dentist.
DHMO plans are “closed panel” plans; unlike “open panels” in a closed panel you usually only have a single dental office or clinic. As mentioned in this insurance plan, the dentist is paid for each and every procedure they perform; based on contract agreements.
Participating Provider Network (PPO)
Dental PPO works similarly to dental HMO, PPO are also In-Network Providers, but unlike HMO this dental plan allows you to use an Out-of-Network or Non-Participating Providers.
In this insurance plan, the providers make a contract with dentists or dental clinics; both basic and major procedures are usually fully covered and when negotiations are being made an annual maximum benefit is set.
Each year the annual maximum is re-issued; however, if the beneficiary reaches their annual maximum any additional treatment becomes the patient’s responsibility.
An exclusive deal that this insurance plan offers you is that they are both “closed and open panel”. This means you have the following benefits:
- The insurance company makes a contract with a dentist or dental clinic.
- You are allowed to choose your own dentist or clinic
- Most treatments and procedures are fully covered, due to an annual maximum benefit
- The contract makes the dentist agree to discount their patients' fees
Choosing an Insurance Plan
When selecting an Insurance plan, you must be careful; keep in mind that it is your health that could be at stake. Not knowing all the details can make you lose some benefits and affect your oral health.
Please keep in mind these 3 steps:
- Know the basics: know your health needs and what provider(s) can prevent and take care of the problem.
- Understand and know the cost: each plan will cover different percentages of procedures and will have different costs.
- Find your plan: coverage can/will vary per state (even if it is the same company); when looking at the Market, ask questions and obtain as much information as possible.
For patients who do not have any of the insurances listed above, we recommend reading the following information on how to save on dental treatment without insurance.
Check with your representative or with us to determine the best plan for you and your family.
Dental Financing Options at Sani Dental Group
For our foreign patients, Sani Dental Group accepts most dental insurance providers and is committed to ensuring that you make the most of your dental insurance coverage.
Our goal is to help you achieve the smile you've always wanted. We believe that financial concerns should not be a barrier to your dental care.
By working with the financial companies United Medical Credit and Citerra Finance we will be able to assist you with the necessary processing to make paying for your dental care more convenient.
It is important for you to know that for this service you will be charged a convenience fee ranging from 10% to 30%.
For any additional information contact us; we will use all of our resources to assist you, restore your smile, and satisfy all your oral needs.
Disclaimer: Open dentist to help you with your dental needs. We are taking additional special measures following CDC recommendations to ensure your health and safety.