eDental-Plan-Plus.com Blog

by Shane Woods

A Dental insurance or dental benefit plan is viewed upon as a much sought after employee benefit. So financially it makes sense to have a dental benefit plan in place to recruit and retain employees. Moreover, dental health is a very important part of overall employee health and man days lost due to dental problems or dental discomfort of an employee equates to financial loss for the employer.

Unlike most medical conditions, dental maladies and treatments are low risk, predictable and low cost. These factors contribute to offering dental insurance to employees a good option financially. Dental diseases are preventable by maintenance and often involve only maintenance costs like x-rays and examinations. Treatment is rendered cheap due to diagnosis in early stages of the disease. Keeping these financial factors in mind, dental insurance options can also be self funded. History does not show any extremes in costs or utilization of this form of employee benefit.

Selecting the right Dental Insurance Plan

Selecting the right dental plan involves a lot of factors which have to be considered with due care.

Dental insurance plans are basically agreements between the employer and the insurance company. Most plans offered by dental insurance companies allow for part reimbursement of dental treatment expenses. Many plans also discourage certain kind of treatments or allow access to certain of dentists. To consider these points one has to go through the plan very carefully with a toothcomb. For example choosing a dentist is not same as choosing a dentist from “the list”, or if the plan does not cover one kind of treatment, it is wrong to infer that your regular dentist is incompetent.

Many plans do not cover pre existing conditions. Some may not cover implants and so on. Due to these preconditions, the final treatment may be paid for in part only or in insurance parlance you might be reimbursed for LEAT (Lease Expensive Alternative Treatment). Dental insurance plans vary in fixing the UCR (usual, customary, and reasonable) in a certain geographical area. UCR may vary from plan to plan and company to company despite operating in the same area. Therefore fixation of this UCR level would define the liability of the patient. In some plans the patient may have to pay more and in some he may have to pay less depends upon the plan the employer has offered.

Advantages of Offering a Dental Benefits Plan to Employees

Important factors while finalizing on a Dental Insurance Plan

An employee has to ask himself the following before he finalizes on a plan:

Would the employees like to retain the freedom of choosing their own dentists?

Will the mode of treatment be determined by the patient and the dentist?

What type of routine and preventive dental care is covered? Does the plan cover braces, oral surgery, crowns and bridges, root canals and treatment of periodontal diseases?

Will the plan cover all diagnostic, preventive and emergency services? Including preventive services viz. sealants & fluoride treatments, which might result in financial savings to the patient in future? Does it provide for full-mouth x-rays?

What forms of major dental care is covered? Does the plan cover implants, dentures, or treatment for temporomandibular disorders?

Does the plan allow for specialist referrals? If so, has the dentist be limited to “the” list of specialists to choose form?

Does the plan provide for emergencies? What are the provisions made for emergency care when the patient is on tour?

What percentage of monthly premiums goes into actual care and not to administration?

Dental Insurance benefit coverage should be taken into consideration but should not be the deciding factor in choosing the treatment.

Dental Insurance Plan Models

There are numerous dental plans available. Basically they are of two kinds:

Managed care and Fee-for-service.

Managed care dental plans are restricted forms of dental insurance which aim at reducing costs and payouts. They tend to restrict the coverage by limiting the access to care by restrictions (by predefining dentist, specialist, hospital or treatments in form of lists) and restricting level, type and frequency of treatment (usually in form of clauses in the coverage policy).

Fee-for-service dental plans have a freedom of choice options where one can choose their own dentist and the fee is paid as fixed by the dentist.

Advantages of Offering a Dental Benefits Plan to Employees

Kinds of Dental Insurance Plans

Managed Care Dental Plans

Preferred Provider Organization (PPO) plans are plans in which the patient has to select a dentist from a list provided to him. These dentists have agreed to discount their fee by contract with the insurance company. Some PPO plans also allow patients treated by dentists outside their list, where the patient is penalized by excess co-payments and higher deductibles. PPO’s are normally less expensive than indemnity plans in their class.

Keep the following in mind while reviewing a PPO Dental Insurance Plan.

What is the percentage of the premium used for administration?

Will the discount influence patients to change their regular dentist? Will the amount of the discount the dentist ahs to offer affect the number of treatment options for the patient?

What is the liability of the employer in the event of the plan influencing dentist selection or treatment?

What are the criteria of selection of dentists for the plan? Does it have adequate number of dentists under contract? What is the geographic distribution of dentists? Does the PPO dental insurance plan provide for specialist referrals? If so, are the dentists limited to a specialist on the “list” only?

How does the plan provide for emergency treatment? If so then how does the plan provide for emergencies outside the geographical area?

Dental Health Maintenance Organization (DHMO) or Capitation plans are designed in such a way that the patient does not have any financial payout when he goes for treatment. These plans pay the dentists on their “list” a fixed amount of money monthly per enrolled family or individual, regardless of visits. In return, the dentists provides specific types of treatment to the patients who visit him at no charge, any other types of treatments require co-payment. This way, the DHMO is rewarding dentists to keep patients in good health, thereby keeping the costs low. This kind of plan is one of the least expensive.

Factors to consider while reviewing a DHMO plan.

What is the percentage of the premium used for administration?

Does the employer have access to enough information for him to determine the level and amount of treatment rendered to each of the employees?

What is the utilization percentage for patients in this plan? Average waiting period for an initial appointment and average period between appointments has to be given due consideration.

What is the dentist/patient ratio for the DHMO plan? What is the criterion of dentist selection in the program? What is the geographic distribution of dentists?

What percentage of dentists is selected for from those who applied to participate? How many dentists withdrew from the program in the recent past?

What is the rate of compensation for the dentists? Is it sufficient compensation for the needs of the covered patient population? What are the provisions made for dentists in the event of unforeseen utilization?

What are the benefits for patients needing a specialist’s care? How are specialists selected and compensated? Does the plan have adequate specialists?

Does the program provide for any emergency treatment? If so, is it available outside the geographical area?

Fee-for-Service Dental Plans

Direct Reimbursement (DR) plan is a self-funded dental insurance benefit plan which reimburses patients on actual spent on dental care. It is not based on the type of treatment received. The patient has complete freedom in choosing the dentist. The employers are liable to pay a percentage of actual treatment cost, but they do not have to pay monthly premiums for employees who do not need the benefit. Moreover the employer is free of any responsibility to take decisions on mode of treatment due to previous plan selection or sponsorships. Direct Reimbursement Dental Insurance Plan is American Dental Association’s preferred method of dental coverage.
About the Author
For more information on your Insurance try visiting http://www.insurance-help-101.com/where you will find a variety of car insurance tips, information and resources to include a Insurance Blog.

Tim Somers
eDental-Plan-Plus.com

Tim is an AmeriPlan (IBO) Independant Busienss Owner, helping consumers save money on Dental, Vision, Prescription and Medical Benefits.  AmeriPlan is a great Dental Insurance Alternative.  

Dental Health: Easy Home Remedies For Healthy Teeth   by Ashish Jain

Dreaming of getting a million dollar smile? Wont be possible without a good and stunning set of teeth. But how to achieve that? Not a task. All you need is just a little more concern and time for your invaluable possession: your teeth.

Your teeth are made up of three distinct layers, namely enamel, dentine and pulp. Some food particles get accumulated every time you munch on your favorite food. And if you do not clean them regularly, the food that is stuck is converted into lactic acid by the bacterial action. This acid dissolves enamel and dentine and produces a cavity. So to avoid dental problems, it is advisable for you to brush your teeth, twice a day.

To properly remove plaque from your teeth, after brushing, gently massage your gums with your fingers. This activity increases the supply of blood in your gums. Also use a tongue cleaner; for a good and effective tongue cleaning.

Choosing the right kind of toothbrush is very crucial for the over all health of your teeth. A brush with M-shaped bristles is an ideal one. Always go in for soft bristles. Your teeth are constituted of two major elements. They are calcium and phosphorus. These elements help in hardening your teeth and also in the formation of teeth in children. Therefore your diet should be planned in such a manner that you get quite a good amount of both these elements.

Your diet plan also plays a very important role in preventing tooth decay. You should eat considerable amounts of raw foods as they are important for producing friction in your gums. The activity of friction helps in keeping the gums firm and also in removing the plaque.

These raw foods are termed as Detergent Foods. Apart from them millets and sesame seeds are good as they contain considerable amounts of calcium.

Sunflower seeds are also storehouse of various elements. They contain vitamin A, fluoride, phosphorus and calcium. Sunflower seeds also prevent bleeding of gums. Foods like parsley, turnip, beet and radishes, to name a few, contain a green pigment chlorophyll, that help you keep proper health of your teeth.

The old age tree product, Neem sticks are of great help as they are highly rich in chlorophyll. Beside this, Rose water, spirit and peppermint mixed with water makes a refreshing mouthwash.
About the Author
The author writes about a number of different topics. For more information on home remedies visit http://www.newhomeremedies.com/ and also visit the article pages: http://www.newhomeremedies.com/home-remedies/ and http://www.newhomeremedies.com/home-remedies-for-dental/

Tim Somers
eDental-Plan-Plus.com

Tim is an AmeriPlan (IBO) Independant Busienss Owner, helping consumers save money on Dental, Vision, Prescription and Medical Benefits.  AmeriPlan is a great Dental Insurance Alternative.  

For a variety of reasons, our teeth can decay and degrade to the point where implants are necessary. The cost of implants, of course, then becomes an issue.

Dental implants are considered by insurance plans as major dental work. A dental implant is really a metal screw that is placed in the jaw bone. It holds a false tooth or set of false teeth. They are similar to dentures or bridges, but they are permanent. Once they have been placed in the mouth, they act like a natural set of teeth.

Implants are expensive. Dental insurance plans usually only cover around fifty percent of the cost of the procedure. However, many dental plans will not cover implants at all. The cost of implants varies greatly as well. The cost of a single implant can be as low as five hundred dollars. It could also be as high as six thousand dollars. On average, implants costs between $1250 and $3000. In most cases, a patient will need more than one implant done and this causes the cost to rise dramatically. If a complete upper or lower set of implants is needed, the cost could be $15,000 to $30,000. A full restoration of teeth could cost as much as $80,000.

Why are implants so expensive? They require a tremendous amount of work by the dental team. Implants require a great deal of time spent by the dentists in both planning for and executing the implant procedure. An extensive evaluation will be done for each patient. The materials used in implants are expensive on their own. There are also additional costs associated with laboratory fees. Dental implants are not a quick, simple procedure.

As with any type of surgical procedure, there are risks associated with implants. Patients need to be good in health before undergoing dental implants. Healing time after the surgery can take three to six months. Patients who get dental implants need to be able to take good care of their oral health after the surgery.

Patients who are considering dental implants should discuss with their dentist whether they would make a good candidate for the surgery. They also need to decide whether the cost of the implants is worth the results. Some people feel that dental implants are far superior to dentures or bridgework. They want something that is more permanent. With implants, patients do not need to worry about their teeth coming loose. Other patients are willing to put up with a little more inconvenience in order to avoid the high cost of implants. The decision to get implants should be one that a patient makes with their dentist after considering all the pros and cons.

About the Author
Thomas Ajava is with DentistStop.com - your source for affordable dental care.

Tim Somers
eDental-Plan-Plus.com

Tim is an AmeriPlan (IBO) Independant Busienss Owner, helping consumers save money on Dental, Vision, Prescription and Medical Benefits.  AmeriPlan is a great Dental Insurance Alternative.

Despite the health risks, millions of us are still smoking. Besides cancer, smoking can really affect your dental health as well.

In addition to the damage smoking can do to your heart and lungs, it can also have a severe impact on the health of your dental situation. Smokers are over six times more likely to get gum disease than those who do not smoke. Smoking not only damages the teeth, but it makes recovering from any type of dental procedure much more difficult.

Smoking stains the teeth. It turns them a yellowish color. The tar in cigarettes can also leave brown stains on your teeth. Normally, the saliva in the mouth helps to neutralize the pH inside the mouth. This allows the damage done by plaque to the tooth enamel to be corrected. Smoking causes this process to be less effective. Smokers are much more likely to have problems with plaque. They are also more likely to develop calculus, which occurs when plaque hardens on the surface of the teeth. This causes tooth decay to begin.

The use of tobacco can also limit how much blood can get to the tissue of the gums. This has a detrimental effect on the bones and other structures in the mouth. It also causes damage to the tissues in the gum line. It will cause the gums to become inflamed. They will begin to pull away from the tooth. This, combined with the damage to the bones, will often cause teeth to fall out. If the teeth do not fall out, they often have to be pulled out because of pain or infection. Smokers lose their teeth a lot more frequently than non-smokers. Men who smoke lose almost three teeth every ten years. Women average a loss of one and half teeth every ten years.

Smokers have a lot more dental problems than non-smokers. Unfortunately, it is also harder to treat smokers for their dental problems. Smoking is highly discouraged after dental work or oral surgery. Some dentists will not work on a patient who they do not believe will abstain from smoking prior to and after the procedure. Smokers are at high risk to develop dry socket after dental surgery. They also have a much harder time healing from dental surgery. Procedures such as dental implants are often not recommended for smokers because of the continued damage that smoking will do, even after the implants are placed.

The good news is that if a smoker quits smoking, the health of their gums can increase within a year. They won’t be able to undo the damage that has been done, but once they stop smoking, their teeth will be able to hold up much longer. They can receive treatment which can help them repair the damage to their teeth and prevent future damage. Smokers who quit smoking can save their teeth before it is too late.

About the Author
Thomas Ajava is with DentistStop.com - your source for dental health information.

Tim Somers
eDental-Plan-Plus.com

Tim is an AmeriPlan (IBO) Independant Busienss Owner, helping consumers save money on Dental, Vision, Prescription and Medical Benefits.  AmeriPlan is a great Dental Insurance Alternative.