Types of dental plan

Managed Care Dental Plans

Preferred Provider Organization (PPO) plans are plans in which the patient has to choose a dentist from a list provided to him. These dentists have agreed to reduce their costs by contract with the insurance company. Some PPO plans also allow patients treated by dentists outside their list, where the patient is penalized by excess co-payments and higher deductibles. OPP are normally cheaper than the compensation schemes in their classrooms.

What percentage of the premium used for administration?

Is the discount influence patients to change their dentist regularly? The amount of the discount the dentist ahs to offer affect the number of treatment options for patients?

What is the responsibility of the employer in the case of the plane of influence on the choice dentist or treatment?

What are the criteria for selection of dentists for the plan? There a sufficient number of dentists under contract? What is the geographic distribution of dentists? The plan PPO dental insurance plan sent to specialists? If yes, dentists limited to a specialist on the "list" only?

How does the plan provide for emergency treatment? If yes, then how the plan provide for emergencies outside the geographical area?

Dental Health Maintenance Organization (DHMO) or capitation plans are designed so that the patient has no financial payment when he goes for treatment. These compensation plans of the dentists on their "list" of a fixed amount of money monthly per enrolled family or individual, regardless of visits. In return, the dentists provides specific types of treatment for patients who visit him at no charge, other types of treatments require co-payment. In this way, the DHMO is rewarding dentists to keep patients healthy, which keeps costs down. This type of plan is one of the least expensive.

What percentage of the premium used for administration?

The employer has access to information is sufficient to determine the level and amount of treatment provided to each employee?

What percentage of use for patients in this plan? Average waiting period for an initial appointment and the average period between appointments has to be taken into consideration.

What is the dentist / patient ratio for the DHMO plan? What is the criterion for selecting a dentist in the program? What is the geographic distribution of dentists?

What percentage of dentists is selected for those who have asked to participate? How many dentists withdrew from the program in the recent past?

What is the compensation rate for dentists? Is it sufficient compensation for the needs of the patient population covered? What are the arrangements for dentists in the case of the use of contingency?

What are the benefits for patients requiring specialist care? How are specialists selected and compensated? Does the plan have adequate specialists?

The program provides for any emergency treatment? If yes, is it available outside the geographical area?

Fee-for-Service Dental Plans

Direct Reimbursement (DR) plan is a self-funded dental plan insurance benefits that reimburse patients actually spent on dental care.

It is not based on the type of treatment received. The patient has complete freedom in choosing a dentist. Employers are required to pay a percentage of the cost of actual treatment, but they do not pay monthly premiums for employees who do not need the benefit. In addition the employer is free of any responsibility for taking decisions on the mode of treatment due to previous selection or sponsorship plan. Direct Reimbursement dental plan is the preferred American Dental Association dental care.