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DENTAL INSURANCE
This section on DENTAL INSURANCE is provided to
help you make informed decisions when selecting the dental coverage for
either your company, your family or yourself. It is important to understand
the distinction between medical insurance and dental insurance, as well as
between the various dental plans available.
The first important distinction, is to understand that when a dental plan is
purchased by your employer, they are looking at a number of options. Among
these include, what the employee will receive for the money spent, and
probably more importantly, what the plan will cost the company. Not all the
plans offered will provide the patient with the same amount of benefit. For
example, some plans do NOT allow you to select your own dentist, they
require you to switch dentists and go to one who has agreed to work within
their plan limitations. In addition, there are frequency limitations,
alternate procedure limitations, exclusions and more.
The California Dental Association recently released an article which
explained how for an employer to provide $1,000 worth of dental benefits for
the employee, it would cost about $1,050 using a Direct Reimbursement
Program. Under traditional (UCR) indemnity dental insurance programs, the
costs would go up to around $1,300 and with capitation programs, it could go
as high as $1,500. So why would they buy the more expensive programs? When
they are presented to the employers, they are shown in the reverse way,
since an insurance company is in business to make money, they make more when
they sell a plan that provides less benefit to the dentist and more to the
adminstrator of the program. Unfortunately because of this, Direct
Reimbursement Programs are often the last ones employers are told about. In
fact, in an article from the October 5, 1998 ADA News, it stated that only
59% of the decision makers for insurance plans even knew about DR Plans. We
understand that each employer needs to make their own decision based upon
the information they are given and the funds they have available. We suggest
that if you are in a position to influence the choice of plan for your
company, you let the person who is in charge of that read the articles below
regarding Direct Reimbursement and contact the California Dental Association
for further information. We are confident it will save your company money,
while allowing the patient to select the dentist of their choice and have
the maximum dental work done for the money spent by the plan provider.
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