Budget constraints and economic uncertainties may be causing your clients to evaluate their benefits options, such as dental coverage. Do they need dental insurance? Or would a discount dental plan suffice? Both options can help pay for dental procedures. But, one design may be a better choice. Here’s what you should know about dental insurance vs. a discount dental plan.
Dental insurance
For those with employer-sponsored coverage, research shows employees today expect that dental insurance is automatically included in their benefits packages. Many employers cover most of the monthly premium. Or, they may offer access to a quality voluntary dental insurance plan. Retired individuals, or those not eligible for coverage through an employer, can purchase an individual plan online.
Dental insurance benefits usually feature two preventive exams each year. Most plans cover 100% of the cost. A dental exam includes a professional cleaning with routine X-rays – depending on the plan design. It includes a wellness check of the teeth and gums. Plus, the dentist examines the oral tissues, looking for signs of medical conditions the patient may not know about.
Dental insurance coverage helps pay for the cost of other dental procedures at different levels, such as basic services like fillings being covered up to 80%. Major dental services such as a crown, root canal or extraction could be covered up to 50%. The plan member is responsible for the remainder of the billed fee.
Patients with dental insurance that includes a nationwide PPO network of dental providers could save an average of 25% – 50% by visiting a network provider. In addition, why not offer a dental plan backed by a reputable insurance carrier offering perks, such as the dental cost estimator tool provided by Ameritas?
Types of dental insurance plans
According to the American Dental Association, there are many dental insurance plans to choose from:
Preferred Provider Organization (PPO) – This option features the benefits of a traditional plan with access to an extensive network of dental providers. PPO plans promote in-network dentists for the most savings because network providers agree to charge a reduced amount for covered dental procedures. Plan members can receive coverage with any provider. Out-of-network benefits can vary. These plans have an annual maximum benefit, reflecting a yearly amount available for dental services.
Dental Health Maintenance Organization (DHMO) – DHMO dentists are paid monthly in return for providing their DHMO patients covered dental services at no or low cost. In some cases, the price for a DHMO plan is lower than for a PPO plan. But members can only visit a dentist in the approved network to receive coverage for dental care.
Discount dental (not technically insurance) – With discount dental, members usually pay a monthly or yearly membership fee. In return, they receive discounts on common dental care services from a specific network of dental providers. These providers also may receive or charge a flat, discounted fee for each dental service they perform. Also known as a dental savings plan, discount dental may be ok in the short term for healthy individuals who don’t require much dental care.
Indemnity insurance plan – Members can see any dentist and receive coverage with a traditional indemnity dental plan. These plans may cost more, but the benefits may be worth it. Members pay costs not covered by the plan at the dentist’s usual fee.
Other dental plans
There are direct-reimbursement plans, point-of-service plans, other limited network plans and scheduled benefit plans. If you work with a carrier offering these types of plans, ask for clarification on the benefits so you can help your clients decide what works best for them.
Remember, dental plans have an annual renewal. So if your clients want to change dental plans or choose a different dental insurance carrier, or both, they can find a new plan that meets their evolving needs.
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