In part three of our three-part series on offering dental health benefits to your employees, we will review all of the dental insurance options available to employers so that hopefully they can make an educated decision when choosing what is best for their employees.
So, what are the kinds of dental insurance plans an employer can offer?
Fee-for-Service Dental Plans
A Direct Reimbursement (DR) plan is one in which the kind of treatment the patients receive is not decided by the treatment plan. The patients are reimbursed on the money spend on the dental care given. This plan is very flexible in the sense that it allows the patients to choose a dentist and the treatment of their choice.
The employers have little control on the mode of treatment and are free from paying any premiums for patients who do not need the dental coverage. The American Dental Association also prefers this coverage, as this plan allows for a certain degree of freedom as far as treatment is concerned.
Managed Care Dental Plans
In the Preferred Provider Organization (PPO) plans, the employees do not have the option of choosing a dentist. They have to make a choice from the list provided to them. The dentists have a contract with the insurance company and provide a reduced rate of service. In some cases, the employees are allowed to contact any other dentist. This, however, involves higher fees and more deductibles. These plans are considered less expensive than indemnity plans.
The employees should get some more information about the details of the PPO Dental Insurance Plan. The foremost information that they should have is how much of the premium is paid toward the treatment and administration charges involved and how far the employer is responsible for choosing the dentist and treatment. In addition, patients should find out how the discount that the dentist provides affects the level of treatment and the frequency of visits to the doctor.
While selecting this plan, employees should look at the list of dentists under the plan, including specialists and the location of these health professionals. They should also determine whether they are allowed to choose a dentist or specialist outside the list provided to them. It is also important to make sure that you know your coverage in case of an emergency and treatment outside of your city or state.
Dental Health Maintenance Organization (DHMO) or Capitation plans are the least expensive plans. Under this plan, the dentist gets a pay every month for every employee or family member. Therefore, the employee does not have to pay anything when he/she visit the dentist for regular checkups or basic treatments included the plan. The principle of this plan is to provide the employees with the basic dental treatment to keep them healthy. In case a specialized treatment that is not covered in the plan is required, the employees have to pay a certain percentage.
Before selecting the DHMO plan, the employees should review it carefully. Some of the common questions that employees have about their dental coverage is how much of the premium is used for the treatment, how much goes toward paying the administration charges, how much responsibility does the employer have in choosing the dentist and the type of treatment, the criteria for the selection of the dentist and where he/she is located, emergency treatment, and type of coverage included in other geographical locations.
Other points of consideration include the waiting period for treatment, the compensation each dentist gets from the plan, the rate of selection, and withdrawal of dentists from the plan so that the employees can determine if there are sufficient health professionals included in the plan. Having complete knowledge about the specialists included in the plan helps patients when they need additional care and have to consult a specialist along with their dentist.