Advantages of Offering a Dental Benefits Plan to Employees (Part
2 of 3)
Important factors while finalizing on a Dental Insurance Plan
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.