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| The Basics | Finding a dental plan doesn't have to hurt
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Brush up on insurance, discount and direct-reimbursement plans so you can pick the best option. Plus, 8 questions to ask before plunking down your money.
By Insure.com
While kinder, gentler technology has taken some of the fear out of a visit to the dentist, access to dental benefits can be challenging. There is hope: Dental benefits can be affordable, even if they aren't provided through your job.
While you might not need to buy a dental plan if you rarely have dental problems, you might want to join one if you've had a rough dental history or if you know you'll need a lot of dental treatment in the near future.
As for your children, if they qualify for the federal/state Children's Health Insurance Program (CHIP), they might be provided with dental benefits. CHIP plans are not required to offer dental treatment. The decision is made on a state-by-state basis.
If you work at a company with more than 500 employees, you're probably among the 175 million Americans who have a dental plan. About 89% of large employers offer some type of dental benefit to their workers, according to the National Association of Dental Plans (NADP).
When you take both large and small employers into account, the number of employers offering dental insurance drops to 54%. According to the NADP, about 40% of the U.S. workforce still lacks dental benefits.
Dental insurance vs. discount plans
Some consumers are confused by the differences between dental insurance and dental "discount" plans. With dental insurance, you pay regular premiums for your coverage and your plan has annual spending caps. It generally covers 100% of the cost of preventive services after you meet your deductible.
Dental-discount plans are not insurance and they work differently. These are membership-based programs. In exchange for a fee, members get discounts on a variety of dental services, such as fillings, braces, exams and routine cleanings. Members typically receive about 30% off standard out-of-pocket prices. They are similar to "diner's clubs," in which you buy a book of coupons and get a percentage off of your meals at participating restaurants.
With a dental-discount plan, you must go to a dentist who has agreed to participate in the plan and offer services at a discounted price -- say $650 for a crown instead of the standard rate of $750 to $850.
Some typical features of these plans:- An initial enrollment fee.
- A monthly fee to the discount company.
- Discounts on cosmetic procedures that are excluded from most dental insurance plans.
Be aware that dental-discount plans are not regulated by state insurance departments. That doesn't mean these plans aren't legitimate, but you should take precautions when buying one.
8 questions to ask before saying aaaah
According to the NADP, these are some questions you should always ask when considering a dental insurance or discount plan:
Are you licensed to offer this plan in this state? True dental insurers must be licensed in your state to sell dental insurance.
Are you registered with the Better Business Bureau? The BBB maintains a large database of companies, where they operate, contact information and complaint data.
Where are you located and what is your address? A bogus dental plan is likely to be hesitant to give you this information, or it will give you an address that is nothing more than a local post office box.
Can you mail me specifics on the plan before I sign up? Fraudulent plans are more likely to collect your "membership fee" before they will send you any information. All legitimate plans have marketing materials that they will be more than happy to send you.
Do you have a Web site with more information? Most legitimate dental-plan companies have extensive Web sites that outline their plan benefits, approximate costs and the providers accepting the plan in your area.
Can I get a list of providers on the plan? Avoid any plan that cannot provide you with a list of dentists who accept their plan.
Can I think about it and get back to you next week? Bogus plans use high-pressure techniques to get you to join the day you call.
Is your plan endorsed by or affiliated with a legitimate national organization? According to the NADP, a recent bogus dental plan said it was endorsed by the "United Dental Association." There is no such organization.
Direct-reimbursement plans
Another entrant to the dental-benefits market is the direct-reimbursement plan. This is a self-funded benefit plan (not insurance) in which an employer pays for dental care with its own funds, rather than paying premiums to an insurance company or having a third party process claims. You, the patient, pay the full amount directly to your dentist, then get a receipt for the services. You then show the receipt to your employer. The employer reimburses you for part or all of the dental costs, depending on your specific benefits.
Some features of a direct reimbursement plan:- Neither you nor your employer pays monthly premiums.
- Freedom to choose any dentist.
- Employer's cost depends on the number of employees and benefit caps.
- Benefits are usually capped at $500 to $1,500 annually.
Have your employer help
If you aren't happy with these dental plans, or they aren't available in your area, you have another option. Ask your employer to help out. Many insurance companies have devised creative ways for employers to offer dental benefits without reaching into their own wallets. Most dental plans can be offered through what is known as a "voluntary group plan" by your employer. You and your colleagues who want to participate pay all the premiums or fees, not your employer. Your employer merely acts as the conduit through which the plan is offered.
Not only do you get access to a dental plan, but you get it at the lower-cost group rate.
Copyright insure.com. All rights reserved.
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MSN Money's editorial goal is to provide a forum for personal finance and investment ideas. Our articles, columns, message board posts and other features should not be construed as investment advice, nor does their appearance imply an endorsement by Microsoft of any specific security or trading strategy. An investor's best course of action must be based on individual circumstances.
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