As we all know medical treatments and facilities are very expensive in today’s world of technology and when it comes to dentistry, everything is costly that an ordinary person can’t easily afford and this is the reason why some patients hunt for a low priced dentist.
By opting for a dental practice to become a good practicing dentist, one actually signs up to pay huge amounts for dental education and dental practices. The first dental practice has an average cost around $1 million. Yes i.e. $500,000 is the starting price tag for entering into dentistry in USA and of course the starting prices do not include the overhead marketing costs needed to operate successful dental businesses. So today it is necessary to be very straight forward with your dentist for clear understanding of all parts of your budget.
The most common method for funding the payment for dental bills is insurance plan. However some families pay for the policy from their own pocket and some use the plan which is provided by their employer. Generally dentistry is not covered by insurance, not even the dental policies which you purchased by your own or those offering coverage plan that you get through your employer. These all methods have limited list of procedures that will be under taken and each plan is different as well.
One of the most flexible dental plans is Indemnity plans including PPO plans. Many insurance companies underwrite the dental coverage in any one of these two categories. Different payouts for different service levels are also provided by the companies. Here be sure that every insurance plan is not categorized the services in same way and that’s why you need to read your plan carefully. For example, a company may cover 100% of the dental bill for all categories whereas another one covers only 60% of it.
Mostly first time patients who are using their insurance don’t realize that there is a maximum coverage for each dental plan per year for these insurance services and you must pick up the rest of the bills, once you have exceeded that yearly amount.
PPO dental plans are sub category of an indemnity plan, however an individual can visit any dentist in an indemnity plan, PPO plans do not allow the same. Just like indemnity plans, annual maximum is present in PPO plans but the coverage % is based on a set of contracted fees on which dentist has agreed to.
Indemnity Dental Plan
Advantages: Without any restrictions patients may visit any dentist that they want and depending on individual plan, dental care cost may be covered up to $2000.
Disadvantages: The amount of coverage may not justify by the cost of an indemnity dental plan and is limited to a certain amount per year. Each service level is based on the insurance company’s arbitrary average market fees.
PPO (Preferred Provider Organization)
Advantages: Dental care cost may be covered up to around $2,000, depending on the individual plan, which will only actually cover routine dental maintenance. Once it’s gone, you have to wait till the end of the year for more funds and the cost is comparatively less than an indemnity dental plan.
Disadvantages: Patients have limited options to choose as certain providers found on the network list. Each service level has different coverage percentage and is not necessarily covered in the actual billing of the dentist you are visiting.
Capitation or HMO Dental Plans
Capitation dental plans are cheaper alternative to regular plan such as indemnities. These are good for those patients whose teeth are in good to excellent condition. But a patient without healthy dental situation may suffer from an HMO plan. In these plans, dentists agreed to a fee schedule that has very low or no co-pay for the patient. Most of the patients get attracted towards it because they don’t know that insurance company pays a cap fee per patient and the amount can range from one to twenty per patient. As a result your dentist starts using poor work practices and most of the patients lose their teeth and are even not able to afford dentures.
Advantages: With a minimal amount of pay, it is a very affordable dental plan and generally has no maximum annual limit of coverage.
Disadvantages: Limited network of providers are available for patients and typically dentist is a beginner who usually will accept the insurance company’s term.
Various people don’t know what costs are they facing in relation to the actual coverage. So you need to make your selection of carriers that fit your own unique criteria including location, age and etc. Contact them and collect all related information and once you have all information, don’t forget to review all policies or terms and conditions of the company.