DENTAL PLANSTraditional PlansTraditional dental plans reimburse you for all or a portion of the usual and customary charges for preventive dental care. After receiving services from the dentist of your choice, you must file a claim. If your dentist is a member of the network, you may be charged an even lower rate due to a negotiated discount rate between the dentist and the carrier. If you incur a charge for a service or supply that is considered higher than the usual and customary charge in your geographic area, only the usually and customary charge is covered. Generally, a charge by your dentist or by any other dental provider is considered usual and customary if it does not exceed the usual and customary charge for the service or supply by others of similar profession in the same geographic area. The specific benefits of each plan vary from provider to provider, but as a general rule, traditional plans are reimbursement plans, usually subject to a deductible and coinsurance. It is also common for a traditional plan to have a maximum benefit ranging from $1,000 to $2,000 per calendar year. Discount PlansIn recent years discounted plans have become much more popular than traditional plans. Discount dental services negotiate a reduced fee with the dentists within their networks helping you save up to 60% off of regular prices. As a general rule, discount plans are not subject to deductibles or coinsurance and have no annual maximums or minimums. There are no claim forms required, waiting periods or pre-existing condition exclusions. Although there are no out of network benefits covered, there is usually no referral necessary to see a specialist. Discount dental plans tend to be very affordable and sometimes offer limited vision benefits as well as basic prescription drug coverage. |
