An
employee has to ask himself the following before he finalizes on a plan:
Would the employees like to retain
the freedom of choosing their own dentists?
Will the
mode of treatment be determined by the patient and the dentist?
What type of routine and
preventive dental care is covered? Does the plan cover braces, oral surgery, crowns
and bridges, root canals and treatment of periodontal diseases?
Will the plan cover all diagnostic,
preventive and emergency services? Including preventive services viz. sealants &
fluoride treatments, which might result in financial savings to the patient in
future? Does it provide for full-mouth x-rays?
What forms of major dental
care is covered? Does the plan cover implants, dentures, or treatment for
temporomandibular disorders?
Does the plan allow for specialist
referrals? If so, has the dentist be limited to “the” list of specialists to choose
form?
Does the plan provide for emergencies?
What are the provisions made for emergency care when the patient is on tour?
What percentage of monthly
premiums goes into actual care and not to administration?
Dental
Insurance benefit coverage should be taken into consideration but should not be
the deciding factor in choosing the treatment.
Dental Insurance Plan Models
There
are numerous dental plans available. Basically they are of two kinds:
Managed
care and Fee-for-service.
Managed
care dental plans are restricted forms of dental insurance which aim at
reducing costs and payouts. They tend to restrict the coverage by limiting the
access to care by restrictions (by predefining dentist, specialist, hospital or
treatments in form of lists) and restricting level, type and frequency of treatment
(usually in form of clauses in the coverage policy).
Fee-for-service dental
plans have a freedom of choice options where one can choose their own dentist
and the fee is paid as fixed by the dentist.
