In my opinion... Dental insurance / Dental Plans When you see a dentist with insurance they are paid a percentage of the bill in cash from the insurance company, a percentage is discounted for being in the network, and you pay the balance. When you see a dentist on a Co-pay plan, your Co-pay may be all they receive. On better plans the provider is paid a set dollar amount from the plan every month you are on their patient list. Group and individual dental insurance are not the same. When an employer offers dental insurance to all of their employees the insurance company assumes not all of the employees will be using a plan for more than preventative services. On individual insurance they know they will be receiving a high percentage of claims because most people looking for individual dental coverage already need dental treatment. If you need dental work done now a discount plan may be your best option. Sam Schoppenhorst
Discount Plans... "Discount" plans are NOT insurance"
When you enroll in a "Dental Plan" you will choose a Dentist /Dental office where you will receive all of your care. The plan prints rosters/member lists and sends them to the dental providers. Generally speaking, they will not make new member appointments until you are on their roster/member list. Before choosing a provider we the highly recommend that you (1) call providers and ask them if they are taking new patients on the (for example) Employers Dental Plan. If they say, " yes we are still taking more people..., you might want to look for another office. (2) Ask... " If I am a new member on your plan on the first of next month, how long will it take to get the new patient appointment?" 4 to 6 weeks may be a typical answer. If they say 2 to 3 months we suggest you keep looking for another office.
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Individual Plan Coverage Booklet Rates and individual Plan - Enrollment Form Dentist Search Over the years we have had great success with this plan. The biggest downside is if your current dentist doesn't accept the plan you will need to choose a new dentist. |
All plan information, providers and enrollment online. |
Dental Insurance...
In my opinion…If
you are looking for “insurance “to pay for services you need now, consider the
following. It may be better to ask
your dentist for a cash discount or try a new dentist on a discount plan. When
an insurance company issues a group dental insurance policy they expect a few of
the new employees will immediately see a dentist for needed services.
When they issue individual insurance they expect the new member will
immediately seek dental services. Let’s
say a typical plan has an annual benefit of $1,000 per person after a $50
deductible and cost $40 per month.
With no waiting period you could collect your annual $1,000 benefit in a month
or two after which you would stop paying your monthly premium because you
couldn’t collect any benefits for the next 10 or 11 months.
The only way individual dental insurance can be profitable is to have
major waiting periods. you need to consider
deductible, annual benefit, waiting periods for different levels of service,
which services are on each benefit level (they are not all the same), what
percent do they pay, and... if it pays 80% of reasonable and customary charges,
you need to know the numerical value of R&C. It could be 80% of 50%, or it
could be 80% of 90%.
In my opinion, Sam Schoppenhorst
We currently do not have individual dental insurance we can recommend.
Please read carefully... If the plan
says it will pay $1500 a year while you only pay a $500 a year... What's the
catch???
Not
counting exclusions and limitations look at the low percentage it pays the first
year, and remember that percentage is what they consider reasonable and
customary. What is a Reasonable and Customary Fee?
This plan reimburses you for covered dental expenses based upon "Reasonable and
Customary" fees. Reasonable and Customary fees are charges that do not exceed
the general level of charges being made by other providers of dental services in
the geographic area where the charge is incurred.
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