Insurance Online

Let’s consider each kind of dental insurance in more detail…

I would like to tell you about the following plans:
I. Dental Indemnity insurance
II. Direct reimbursement
III. PPO (Professional Provider Organization)
IV. HMO (Health Maintenance Organization)
V. Dental discount plans

So, the first kind of dental insurance….

I. Dental Indemnity insurance

It is the traditional plan of insurance in which you pay for service (fee-for-service). The insurance company pays the certain percent for so-called UCR - usual, customary and reasonable (service). These payments are based on the average prices. There is commonly encountered situation: the insurance covers 100 % of your expenses for preventive maintenance of dental diseases (medical examination, cleaning of teeth and X-ray photography), 80 % of expenses for the basic treatment (simple tooth stopping, extraction of a tooth), and 50 % of expenses for the specialized treatment (root canal treatment, crown of tooth, bridges, other kinds of prosthetics).

Thus, the patient pays nothing for preventive maintenance; 20 % from the sum for the basic treatment pay, and pays 50 % of the specialized treatment. Usually there is a limit of the sum which the insurance company is ready to pay a year.

For example: from January, 1 till December, 31 the insurance company has established a limit of the sum - $1000. If the patient exceeds this figure, let it be $1200. In this case these $200 he pays from his own pocket since under the contract the insurance is not distributed to the sums above $1000. Therefore, it will be quite reasonable to make some treatment in one calendar year, and the rest - to transfer to the next.

Features of the plan:

1) High, not compensated, initial investments ($20-50). Usually well developed plans do not apply not compensated payments to preventive services;
2) Annual limit of the amount of compensation;
3) An opportunity to choice the dentist at own will;
4) Average expenses $19-50 a month;
5) The companies selling this plan, submit to State Department of insurance.

<:3 )~~~~~~
Yours sincerely,
AlexSandra

This entry was posted on Tuesday, August 22nd, 2006 at 6:28 pm and is filed under Dental insurance. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.