There are several dental insurance plans. It is, therefore, important for patients to select the most appropriate plan. There are four major categories of dental insurance. The Direct Reimbursement category reimburses a predetermined rate of the total dental care cost. This method enables the patient and the dentist to select healthy and affordable oral health insurance.
Usual, Customary, and Reasonable (UCR) health plan gives the patient the chance to select the preferred dentist. The plan caters for a predetermined proportion of the dentist fee.
Schedule of Allowance category uses a list of available services with the assigned amount. Capitation healthcare plan pays fixed amount at a regular period to contracted dentists.
Understanding oral health insurance plans
Dental insurance plans use predetermined costs. The eligibility of the patient is determined, and also the payment proportion of the patient. The dental health plan has an annual limitation of benefits. To reduce costs, the insurance plan limits benefits based on procedures or cost per annum.
The insurance plans have peer review in the area of dispute resolution. Disputes involving the patient, dentists, and insurance providers are handled through peer review process.
Factors to consider when choosing dental insurance plan
The plan should give the patient the freedom of selecting his or her preferred dentist. The suitable plan enables the patient to participate in making major treatment decisions.
The oral health insurance should cater for additional healthcare services such as diagnostic or emergency services. A suitable plan allows for referrals to oral health specialists. Specialists have sufficient knowledge on effective dental treatment.
Major points for dental insurance
The dental insurance premiums should be regularly reviewed to ensure equity of the URT or the Schedule of Allowances plans. It is advisable to select dental insurance that has service or amount limitations, as opposed to the plans that exclude some services.
Patients who have two dental plans can get maximum benefits. Patients are advised to immediately inform the insurance administrator about the dual coverage status.