Dental Insurance - Managed Care

A majority of Americans participate in some form of managed care dental insurance plan. These can include: health maintenance organizations (HMO's), preferred provider organizations (PPO's) and point-of-service (POS) plans. This type of plan provides comprehensive health services to members as well as financial incentives to those who use the providers in the plan. This kind of plan can restrict your choice of professional as well as treatments for a condition.

A PPO Dental insurance plan means that you will select a Dentist from a network of providers who have agreed to work within this network and will discount their fees accordingly. In the case that you choose to see a Dentist outside of your PPO you will likely be penalized with a higher deductible and co-payment level. However, the advantage is that PPO's are usually less expensive than other comparable dental insurance plans. Why? The risk is spread over a group of patients AND professionals. The professionals discount dental services in return for a 'captive' patient population. The patients agree to work within the network of professionals associated with the PPO, which means the dental insurance company pays less money out on claims. In practice everyone can win, but only if you are getting the care you want.

The other type of managed care dental insurance arrangement is the Dental Health Maintenance Organization or Capitation Plan. These dental insurance networks pay a contracted professional a fixed amount per enrolled individual and family. The Physician is the one who absorbs a significant part of the risk. If your family happens to need intensive dental treatment the Dentist may actually be losing money on you. However, the risk to the Dentist is spread out over the Dentist's patient population - and some Dentists like the 'ease' of the billing arrangement. What about you? You benefit because specific kinds of dental treatment, both preventative and curative, are provided without a direct charge. The intent is to reward people who maintain the health of their teeth. Also, this type of dental insurance is typically the least expensive. However, if you need certain dental procedures, outside of the Dental HMO's covered services, you will have to pay.

Don't forget to check out the how do I choose a dental insurance policy, dental insurance - fee for service, dental insurance - managed care, group dental insurance and individual dental insurance and dental insurance plan questions pages and click the links above to get started comparing dental insurance plans.

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