by avengerki » Tue Apr 29, 2008 08:47 pm
What are the dental insurance plans to go for?
Dental insurance plans are primarily of 2 types:
Indemnity/fee-for-service plans
This plan allows the insured to pick a dental care professional of his choice from the existing network of the insurance company. The claim may be then forwarded to the insurance company. You will be reimbursed for part or all of your dental care as mentioned in the policy. This plan may be favorable for those who seek more options in dental care.
Managed Care plans:
Managed care is classified into:
Dental plans too, like so many other policies can be opted either under individual plans and group plans.
Individual Dental Insurance:
Individual dental insurance is a very popular form of coverage and is sold directly by the insurance company to its client. However, this policy is not easy to find. Some employers may provide such coverage. Insurance companies often sell these plans as “referral plans” and sometimes also as “buyers' clubs”.
Group Dental Insurance
It is recommended by experts that you should get a group dental insurance if you can. It costs less than an individual dental insurance policy and also provides the most comprehensive care. There are several group dental plans where you may also declare dependents in which case you may be allowed to insure your entire family. This group dental plan helps in reducing the cost of dental care to a great extent.
What are the benefits of a group dental insurance policy?
In a group dental insurance policy, the insurance provider offers coverage for an entire group instead of an individual alone. The benefits include:
Family Dental Insurance
Family dental insurance is an effective plan created for couples and their children. Such plans may also offer free or low cost service for younger children in your family. Costs for check ups, cleaning, dental x-rays, orthodontics, fillings, and root canals may be lowered as a result of this family dental insurance. Many employers too may offer such a family plan for their employees. If not you can get one on your own.
Family dental insurance has 3 major types:
Dental insurance plans are primarily of 2 types:
- 1. Indemnity plans
2. Managed Care Plans
Indemnity/fee-for-service plans
This plan allows the insured to pick a dental care professional of his choice from the existing network of the insurance company. The claim may be then forwarded to the insurance company. You will be reimbursed for part or all of your dental care as mentioned in the policy. This plan may be favorable for those who seek more options in dental care.
Managed Care plans:
Managed care is classified into:
- Dental Preferred Provider Organization (PPO) Insurance Plan: The PPO plan allows individuals to avail treatment and discounts from dentists who are a part of a network. This insurance plan allows you to visit dentists outside the network too, but in this case it may cost you more than what your plan covers.
- Dental Health Maintenance Organization (DHMO) Insurance Plans: There is a group of dentists who are part of the network formed by the DHMO. Only individuals covered under family DHMO or individual DHMO can avail the services. If you are not a part of the same plan then you are not entitled to any coverage.
- Dental Point of Service (POS) Insurance Plans: In this plan there are 2 options. You can either visit a dentist who is part of the insurance plan network or you may visit a dentist outside the insurance plan network. If you choose to visit a dentist who is outside the network, you will end up paying more.
Dental plans too, like so many other policies can be opted either under individual plans and group plans.
Individual Dental Insurance:
Individual dental insurance is a very popular form of coverage and is sold directly by the insurance company to its client. However, this policy is not easy to find. Some employers may provide such coverage. Insurance companies often sell these plans as “referral plans” and sometimes also as “buyers' clubs”.
Group Dental Insurance
It is recommended by experts that you should get a group dental insurance if you can. It costs less than an individual dental insurance policy and also provides the most comprehensive care. There are several group dental plans where you may also declare dependents in which case you may be allowed to insure your entire family. This group dental plan helps in reducing the cost of dental care to a great extent.
What are the benefits of a group dental insurance policy?
In a group dental insurance policy, the insurance provider offers coverage for an entire group instead of an individual alone. The benefits include:
- Insurance providers who offer group insurance mostly charge lower monthly or yearly premiums. The entire group in this insurance policy helps keep the dental insurance costs down.
- Individual plans and many discount plans cover preventive and diagnostic care. But group dental insurance plans allow the insured to cover their family members, major dental work, orthodontic treatments and children.
- Group dental insurance plans often offer their members a wide range of services. Special discounts on family plans, special offers on individual plans for single employees, and special plans for employees who are in need of extra care. Many insurance providers offer such plans in a group policy that meets the requirements of individual members. This means that the insured (you) can get the benefits at prices that is affordable for them.
- Employers can retain more employees if they provide such benefits like dental coverage. Companies and organizations offering such group dental insurance may be entitled to or may claim tax benefits as a result.
Family Dental Insurance
Family dental insurance is an effective plan created for couples and their children. Such plans may also offer free or low cost service for younger children in your family. Costs for check ups, cleaning, dental x-rays, orthodontics, fillings, and root canals may be lowered as a result of this family dental insurance. Many employers too may offer such a family plan for their employees. If not you can get one on your own.
Family dental insurance has 3 major types:
- Family Managed Care Dental Insurance – Many individuals go for managed care insurance because the out-of-pocket costs for family dental DHMO and PPO becomes lesser with every visit. However, in this case you need to visit a dentist who is part of the approved network.
- Family Indemnity Dental Insurance – This plan gives you the liberty to choose the dentist you or your family members would like to visit. There may be a certain amount of deductible that you will be entitled to pay to receive dental care. You and your family will receive more flexibility in terms of benefits and services with this plan.
- Family Discount Dental Plans – The program under family discount dental plans provides many dental services at lower costs. The advantage of such a plan is that as a member you will be provided with a discount card which you may present to the enlisted dentist to avail the discount.
Posted: Tue Nov 18, 2008 01:45 am Post Subject: dental
Now.........I can FINALLY get all of this dental work done that I need. I feel 'pretty good' about all of this. I have a pretty 'high pain threshold', but...when it comes to a toothache..OOUUUCCCCHHH!! Holy COW!!! I had a tooth infection, in late October. Was REALLY having a problem with it.
Posted: Tue Nov 18, 2008 03:27 am Post Subject:
You never should put off a tooth infection whether you have insurance or not SD. A tooth infection can travel straight to the brain and kill you!!! I heard of a guy from around my area that ended up ion intensive care over an infected tooth. He ended up having to have the teeth taken out. The insurance company wasn't going to pay the bill since it had to do wiht dental except sonce it was life or death they did pay. Seriously...do not let one go too far.
Posted: Wed Nov 19, 2008 04:55 am Post Subject: dental
Trust me.....even if I DIN'T have Dental Insurance, i would have gone SOMEWHERE!! Had to go to the Emergency Room, a few times, because I was in SOOO much pain. Doctor wrote out an Anti-botic and a pinkiller...enough for a few days, until I got to a dentist. Boy..I was hurting. FINALLY got it taken care of. :)
Posted: Fri Aug 06, 2010 09:41 pm Post Subject: info
it does cover that stuff, you just have to be in it at least a year to cover the “major stuff”
I also was apprehensive about this plan but after checking plans and calling a few dentists the info I get is your gona pay for this stuff one way or another and all plans seem to have a waiting period for major items, and ALL have some kind of co pays and deductible. What all I read the TriCAre plan seems to be fair on this stuff, although I agree the whole plan could have been written a bit better. As in my case as a 27 year retiree I was told I’d HAVE FREE care for life. So the only thing a retiree (or dependent) has is this plan and hope the Senate or Congress gets a better deal for us at some point.
I just found yesterday after paying $204 for a cleaning and a couple Xrays I needed perio work and a crown my cost would be $2,338, with no ins.
So with ins at least I can get a break on the perio as its included right off, the crown will have to wait a year. So I decided to join up this month and become effective the 1st Sept. So I can start the perio work at least.
============================================================
Benefits available during the first 12 months of enrollment: *Delta Dental Pays:
Diagnostic services(such as exams) 100%
Preventive services(such as cleanings) 100%
Basic Restorative services(such as fillings, including tooth-colored fillings on back teeth) 80%
Endodontics(such as root canals) 60%
Periodontics(such as gum treatment) 60%
Oral Surgery(such as extractions) 60%
Emergency (such as treatment for minor pain) 80%
Dental Accident Coverage 100%
==============================================================
Additional services available after 12 months of continuous enrollment or if enrolled within four months after retirement:
Cast Crowns, Onlays & Bridges 50%
Partial/Full Dentures 50%
Dental Implant Services 50%
Orthodontics 50%
============================================================
Deductibles & Maximums
Annual Deductible
per person $50
$150 cap per family, per benefit year
Annual Maximum (per person, per benefit year) $1200
Orthodontic Maximum (per person, per lifetime) $1500
Dental Accident Maximum
(per person, per benefit year) $1000
Benefit Year: October 1- September 30
*The percentage paid by Delta is based on the allowed amount for each procedure. While the coverage percentage is the same for all TRDP patients, total out-of-pocket costs may be higher if care is received from a non-network
Posted: Fri Aug 06, 2010 09:48 pm Post Subject: tricare dental
it does cover that stuff, you just have to be in it at least a year to cover the “major stuff”
I also was apprehensive about this plan but after checking plans and calling a few dentists the info I get is your gona pay for this stuff one way or another and all plans seem to have a waiting period for major items, and ALL have some kind of co pays and deductible. What all I read the TriCAre plan seems to be fair on this stuff, although I agree the whole plan could have been written a bit better. As in my case as a 27 year retiree I was told I’d HAVE FREE care for life. So the only thing a retiree (or dependent) has is this plan and hope the Senate or Congress gets a better deal for us at some point.
I just found yesterday after paying $204 for a cleaning and a couple Xrays I needed perio work and a crown my cost would be $2,338, with no ins.
So with ins at least I can get a break on the perio as its included right off, the crown will have to wait a year. So I decided to join up this month and become effective the 1st Sept. So I can start the perio work at least.
============================================================
Benefits available during the first 12 months of enrollment: *Delta Dental Pays:
Diagnostic services(such as exams) 100%
Preventive services(such as cleanings) 100%
Basic Restorative services(such as fillings, including tooth-colored fillings on back teeth) 80%
Endodontics(such as root canals) 60%
Periodontics(such as gum treatment) 60%
Oral Surgery(such as extractions) 60%
Emergency (such as treatment for minor pain) 80%
Dental Accident Coverage 100%
==============================================================
Additional services available after 12 months of continuous enrollment or if enrolled within four months after retirement:
Cast Crowns, Onlays & Bridges 50%
Partial/Full Dentures 50%
Dental Implant Services 50%
Orthodontics 50%
============================================================
Deductibles & Maximums
Annual Deductible
per person $50
$150 cap per family, per benefit year
Annual Maximum (per person, per benefit year) $1200
Orthodontic Maximum (per person, per lifetime) $1500
Dental Accident Maximum
(per person, per benefit year) $1000
Benefit Year: October 1- September 30
*The percentage paid by Delta is based on the allowed amount for each procedure. While the coverage percentage is the same for all TRDP patients, total out-of-pocket costs may be higher if care is received from a non-network
Posted: Sat Aug 07, 2010 10:59 pm Post Subject: tricare dental
only bad thing about it is the cap, at 1200 per year. that is actually 1150 cause you also have a 50 dollar deductible. If not for that the rest is OK.
Posted: Sat Aug 07, 2010 11:01 pm Post Subject: tricare dental
only bad thing about it is the cap, at 1200 per year. that is actually 1150 cause you also have a 50 dollar deductible. If not for that the rest is OK.
Posted: Sat Aug 07, 2010 11:09 pm Post Subject: tricare dental
only bad thing about it is the cap, at 1200 per year. that is actually 1150 cause you also have a 50 dollar deductible. If not for that the rest is OK.
You also HAVE to be enrolled for at least 1 year once you enroll.
I guess its one or the other, your gona pay somebody.
Posted: Mon Aug 09, 2010 06:32 am Post Subject:
the cap, at 1200 per year.
This is usually in excess of the deductible. At least it has been in all of the Delta plans I was ever covered under. And there was no requirement to be covered by the plan for 1 year before benefits were available.
Posted: Mon Aug 09, 2010 08:31 pm Post Subject: tricare dental
Could be about the copay, the year commitment takes effect in 30 days, weather you used it or not. if you don 't call them to cancel, If you use it before that time yeah its effective for the year than too.
Its why I broke down and got it, "to use it", don't have a real warm and fuzzy feeling about it, but that's what it is.
Took it cause of a couple reasons, they back dated my enrollment to the 1st, which let me claim the 204 I just paid for a cleaning and Xrays, also I need periodontal work, and that's covered right off. I did some figuring and all in all I came out about 127 bucks ahead with it rather than pay out of pocket. even when I added in my years worth of premiums.
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