Types of dental insurance plans for employees
Types of dental insurance plans for employees
A dental insurance is an insurance that will provide the person
having dental insurance protection with required financial
assistance for normal dental care and damage occurred to teeth
from accidents, this can be under an individual or group
insurance plan. Dental insurance was once a neglected area, but
the awareness about importance of dental insurance is increasing
alarmingly. In the past dental insurance was treated only as a
perquisite provided by the company to its employees, studies
(Human Resource Management Survey-1999) show that 83% of the
small business provides dental insurance to its employees.
It's advisable for every one to go for dental insurance. Dental
insurance is more affordable and cheap when compared to other
medical insurance. In fact dental insurance costs less than 10%
of the cost of the medical coverage. Like every other type of
insurance dental insurance also offers a number of plans that
you can select from. The major types of dental insurance for
employees are discussed below:
Direct reimbursement plan
This plan works on the amount that the company set aside
specially for this purpose. In this plan the employees are
reimbursed the money that they have spent for dental care. The
most positive aspect of this pan is that it is straight forward
and not involves any complex calculations. This plan is widely
recommended by American Dental Association. Direct reimbursement
plan is considered as most expensive for the employers. Certain
small business finds it difficult to go in tune with this plan
because of the cost factor involved.
Indemnity plans
These plans are more feasible. Under this plan the amount of
premium is paid to the insurance company and the company in turn
pays the amount to the dentists for their treatment. Under this
plan the insurance company generally uses UCR (usual, customary,
and reasonable) for making payment to dentists. In case if the
UCR rate used to pay dentists falls short of dentist's rate, the
patient has to make up the shortfall. The insurance coverage
under this plan are 100% for preventive measures like cleanings,
80% for basic work like a crown or cap, and 50% for major
procedures like oral surgery.
Managed care plans
These plans are treated as the least expensive. These plans
include some cost control measures and are best suited for small
business. This plan wants the patients to pay a certain amount
as co-payment and the co-payments vary according to the
procedure. Preventive procedures are normally performed without
a co-payment and advanced procedures are carried out with a
higher co-payment.
The managed care programs are of two types, they are:
a. Preferred Provider Organization (PRO) Program
Preferred provider organization program consists of a network
of dentists. The dentists who fall under this plan have reduced
their charges with a view to participate in this plan. The
employees can select the dentist from this pool, if the
employees have to go to a dentist not in this pool they have to
pay penalties.
b. Dental Health Maintenance Organization (DHMO) Plan
In this plan also the employees have the right to choose the
dentist from the pool, but in this plan instead of discounting
the fees the dentists provide certain treatments free of cost.
The dentists are paid a fixed amount as fees per individual even
if the patient never ever receives the payment.
The above stated are the various plans of dental insurance
provided by the employer to the employees. It is possible for
the employees to select the best suited plan after analyzing the
advantages and disadvantages of the available options. By
selecting a proper dental insurance
it is possible for the employees to assure the health and safety
of their teeth.
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