Delta Dental Insurance

With the rising cost of dental care, having dental insurance will help you financially. Many people find that their employer will offer dental insurance. There are several types of dental insurance including: HMO, PPO and indemnity plans. Let’s look at how these plans differ from each other:

Indemnity Plans
Indemnity dentalinsurance plans are the traditional forms of dental insurance. The plan allows you to select a dentist of your choice without a penalty. The plan will then pay all or part of the dentist’s fee. The insurance company usually has a set UCR fee (usual, customary and reasonable). This is an established set price for every dental procedure they cover. The dentist may charge more for a certain procedure, but your insurance company will only pay what their UCR guide states.

If your policy requires you to go to an in-network provider, you will not be charged the difference between the dentist’s price and the UCR price. Typically, the contracted dentist and the insurance company write off the difference in charges. If your insurance allows you to pick your own dentist, you may need to check the UCR guide against the dentists charges to make sure you have enough money to cover the out-of-pocket expenses.

Typically, indemnity plans will pay 100% on preventative treatment, 50% to 80% on basic procedures, and 25% to 40% on major treatments. Preventative dental procedures are considered to be routine cleanings, x-rays, sealants, fluoride, and any preventative dental care. Basic or restorative dental procedures are described as fillings for cavities or simple extractions. Root canals are also considered basic procedures. Major dental procedures are considered to be crowns, bridges, dentures, partials, surgical extractions, and dental implants.

Indemnity plans are limited by a yearly maximum amount around $1,000 and there is sometimes a deductible the patient must pay before coverage can begin. The patient will be responsible for any fees not paid by the dental insurance company.

PPOs
Participating or Preferred Provider Plans (PPOs) are similar to indemnity plans. The patient must select their dentist from a listing of dentist’s who have signed an agreement with the insurance company to accept a pre-set fee. The dentist agrees not to charge the patient for any amount that their normal fee exceeds the pre-set fee. This means that under a PPO plan, you will have a pre-set fee of $100, the insurance will pay $80, the dentist will write off $5 by which their fee exceeds the UCR amount, and you will be responsible for $20.

HMOs
Dental Health Maintenance Organization plans are not dental insurance. They are plans in which you must choose a participating dentist in order to receive benefits. There are 2 different types of HMOs: Capitation and Fixed fee for service.

Capitation is when the dentist receives a small monthly payment for each patient they are assigned. The dentist is not paid for preventative care or restorative treatment they provide. However, they are paid the small monthly fee whether they treat you or not.

If your employer doesn’t offer dental insurance, you may be able to buy an individual plan. Many insurance companies can deny you coverage if you have made a large number of claims in the past. Keep in mind that the premiums for individual dental insurance can be quite expensive. Selecting the right dental insurance can be a hard task, start by looking at Delta Dental.

Delta Dental

Delta Dental is the nation’s largest dental insurance company. They have been in business for over 50 years and have set the standard for many other dental insurance companies. Delta Dental is comprised of 39 independent Delta Dental member companies and is available in all 50 states. Delta Dental states they are providing coverage to over 50 million people, enrolled in over 88,000 groups.

Delta Dental offers several different benefit packages. To gain a better understanding of what Delta Dental can offer, let’s look at each package individually.

• Delta Dental Premier
  This package is one of 3 packages contracted on a national network. The dentists who participate in the Delta Dental Premier package agree to processing policies and are not allowed to bill their patients above the pre-negotiated fees. This allows the patient enrolled in the program to save money.
• Delta Dental PPO

This is another package that is contracted on a national network. Again, the dentists agree to accept payment in full for the pre-negotiated fees. The patient is allowed to visit any dentist of their choice, but will save money if they visit a PPO network dentist

• Delta Dental PPO plus Premier

This plan includes the same benefits as Delta Dental PPO. If you choose to go to a participating Delta Dental Premier dentist (outside the PPO network), you will receive the benefits of the provider’s contracted fee. Again, as a patient you can save money and choose a dentist outside the PPO network.

• DeltaCare USA

This is the HMO dental insurance offered by Delta Dental. The members of this policy can select a dentist from a listing provided by Delta Dental. Many companies who are seeking a lower cost dental insurance will subscribe to this plan. As a patient you will not have a co-payment for preventative care and the network dentists will file the claims directly.

• Delta Dental Select

Delta Dental Select is contracted with TriCare to provide benefits for Uniformed Service retirees and their families. Any member of the Retired Reserve who is under age 60 is also eligible for this dental insurance. Any of your children who are under age 21 are also eligible for Delta Dental Select. Some benefits you will enjoy include: immediate coverage with no pre-authorizations or waiting periods, flexibility to choose a dentist of your choice, and the opportunity to enroll family members in the program. Unlike many other dental insurance options for retirees, Delta Dental Select provides low-cost fees, approximately $10 to $15 a month for a single individual, $18 to $30 for two people, and $31 to $48 for a family of 3 or more.

• Delta Dental Patient Direct

Delta Dental Patient Direct is a discounted dental plan for individuals, families, and groups who do not have dental benefits. As a subscriber you will select a dentist provided from a listing of participating dentists and receive discounted fees for their services.

• DeltaVison

This is a vision benefit plan offered in selected areas. Patients can have the benefits of pre-negotiated pricing for professional eye exams, eyewear, contact lens, and laser vision correction. This package is not available in all states.

Delta Dental prides themselves in their quality standards. All dentists who participate in Delta Dental are required to meet certain quality standards and provide information on equipment, radiation safety, cleanliness, patient treatment plans, and other aspects in their practice.

Delta Dental will also arrange for their enrollees to be examined by participating dentists in your area. If you have a problem with a Delta Dental dentist, they will intervene with the dentist to have the work redone and no additional cost to you.

Delta Dental provides many advantages to their members. As an enrollee you do not pay the entire bill and wait for reimbursements from Delta Dental. You will receive a statement of benefits from Delta Dental in which they will show you how much they have paid and how much you will be responsible for. You will not pay until your dentist sends you the invoice for the remaining portion.

Delta Dental has negotiated certain fees with dentists. This means that your dental costs may be lower. Delta Dental will make sure you are not charged extra for any service that is included in the cost of treatment.

Delta Dental is nationally available, which means if you move you can find a new dentist who accepts your insurance. However, if you change jobs, your insurance coverage will be dropped from your employer’s records and you will need to enroll in independent Delta Dental insurance.

The best option you have available is to sign-up for dental insurance through your employer. Employers are given excellent dental plans with Delta Dental because they have a large number of employees who sign up for coverage. This means your employer will pay a large portion of the premium, leaving you will a small amount to pay. Most companies will only make their employees pay around $25.00 or under for family dental insurance plans. Keep in mind, that the more family members you add to your dental insurance, the more you will have to pay toward the premium.

All in all, investing in dental insurance is a smart choice. If your employer is willing to cover most of the premium, you should sign up today. Even if you only go in for 2 cleanings a year, you are still saving yourself money on the exam, cleaning, x-rays, and other charges that could be applied.

Any company who invests in Delta Dental is making a wise choice. With their long-lasting reputation and large network of dentists, it is no wonder why they are the leading dental insurance company.