Individual Dental Plans In Michigan - Dental benefits should be just that – for you and your family. While you don't need dental insurance to receive care, dental insurance can help lower the cost of some treatments.
MDA dentists know that it is important for you to get the most out of your dental plan. Below, we explain how dental plans work and include tips to help you maximize your benefits.
Individual Dental Plans In Michigan
When considering a dental plan, first and foremost, make sure you can visit your own dentist. why Because most dental plans do not consider the doctor / patient relationship. You may be limited to using one dentist in their network. That's why it's so important to choose a plan that allows you to stick with your own dentist.
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Much depends on the plan. Here are some key questions to ask when evaluating a plan:
The answer to all the above questions should be "yes". If the answers are mostly "no," you're probably looking at a limited dental plan. In such cases, your dental health is not the priority of the insurer. If the options are available, you can reevaluate and select the option that gives you a "yes" answer to these questions.
Most dental plans are restrictive. This means they limit their members in two ways - the number of dentists they can choose from and the amount of covered care they can receive.
Most limited dental plans base the amount of treatment on a fixed amount per person rather than a fixed amount per procedure.
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When determining how much care to pay for each patient, these insurance plans base their estimates on what the "average patient" will need. problem? There is no such thing as an average patient.
Limited plans also limit your dentists. These plans don't always cover treatments that are important to your health. Because of this, many dentists choose not to participate in limited plans.
The most common type of limited dental plan is a dental health management plan (aka DHMO plan or HMO dental plan).
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DHMO limits patient coverage to dentists within a specific network. They will not cover or reimburse treatment from dentists outside their network.
Medicare Dental Insurance Coverage
A dental provider plan (aka DPPO or dental PPO) offers more flexible coverage options. DPPOs provide patients with access to dentists within a specific network and allow patients to see dentists outside their network.
DPPO is preferred when visiting a dentist online. They will cover a higher percentage of fees charged by in-network dentists than out-of-network dentists. You may pay a little more to see an out-of-network dentist, but your insurance still provides coverage.
Not all plans have waiting periods. However, dental insurance companies require you to be a paying member for a certain period of time (often 3, 6 or 12 months) before your full coverage is valid.
Insurers argue that the waiting period prevents people from joining the plan when they need dental work, only to cancel when their smile is fixed.
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When you sign up for dental benefits through work, you join a "group policy." Your employer pays the company a set premium that the insurance company uses to pay for your care.
The specifics of a "group policy" depend on your employer's contract with the insurance company. Generally, the higher the premium you and your employer pay, the less you are expected to pay out of pocket.
Your dentist charges you for the actual treatment performed and the time it takes to complete it, plus a portion of the office costs.
Your dental costs include quality staff, state-of-the-art equipment, modern dental materials, current infection control practices and continuing education to ensure your dental team is up to date with the latest technology.
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Most insurance plans use the “usual, prevailing and reasonable” rate, also known as UCR, to determine what part of your dental care they will cover.
The UCR plan will pay a fixed percentage of your dentist's fees or the policy's "fair" or "customary" fee limits, whichever is lower.
These limits are set in the contract you or your employer has with the insurance company. They may not reflect the actual cost of dental care in your area. If a plan's "standard" payment limit is unrealistically low, you may end up paying a larger share of treatment costs.
There are no state or national standards for determining the premiums that insurance companies will pay. Even if two insurance plans are housed in the same building and owned by the same company, plan administrators may set different UCR rates for the same procedure.
Dental Insurance In Michigan
The Michigan Dental Association and its member dentists are committed to the practice of responsible dentistry. When they provide treatment, they evaluate your specific situation and create a treatment plan based on what is best for your dental health. Always.
Your MDA dentist may choose what is medically best rather than what your insurance company deems most cost-effective. Treating you based on the needs and problems of an insurance company's undefined "average" patient impairs your dentist's ability to provide you with the best possible care.
MDA and its dentists believe in protecting your patient's rights. Your insurance company should too. It includes:
If you are missing one or more of these important dental needs, your oral health is likely to be at risk.
Dental Discount Plans
If you receive a letter from your insurance company saying they are denying payment because your dentist's charges are higher than your plan's UCR rate, talk to your dentist. Your insurance company may have outdated information or may not have considered local factors when setting the rate.
If you are still not satisfied after talking to your dentist and your insurance company, talk to your employer, human resources representative or union. Let them know that the benefits they purchased do not meet the needs of their employees.
Only you and your dentist can decide which treatment is right for your needs. MDA dentists do not recommend postponing necessary dental care due to insurance coverage limitations or waiting times. This can be dangerous to your oral health and even more expensive in the long run.
You always have options. Talk to the billing staff or your dentist's office manager about your payment options. Many methods allow you to set up a payment plan so you can pay for uninsured procedures over time and in installments. Others may offer generous discounts for paying in advance for services.
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To read more about dental insurance, check out our other articles on the MDA Smile Connection blog. We think you'll like: QDP's videos on Office Plans (IOPs), explaining what to look for, what to watch out for and how to get started >> Learn more
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Whether you want full service or just the basics to start your own savings plan, QDP is designed to meet your needs. QDP is a complete turnkey program, including training for physicians and teams, nationally branded marketing and public relations programs. QDP offers the lowest fees in the industry while allowing you to use your own practice management software.
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QDP offers a simple fee structure. MDA members donate up to $0.75/patient/month. Lowest rate MDA has found anywhere! Competitors charge $4/patient/month or 5% to 15% subscription fees. do the math With only 250 patients you can pay another company $12,000 or more per year. With QDP, you pay just $2,250 per year for up to 250 participating patients. QDP is the most cost effective option.
Over a period of 10 years, QDP has worked out every detail so that your savings plan runs smoothly from day one. With just a few mouse clicks, you can get your program up and running. QDP services are tested in practices across the country, saving you and your staff the frustration of going back to the drawing board.
Keep managing your schedule simple by using your own exercise management software. Any practice management software can be set up to use QDP effectively. Need automatic billing options? QDP has it too!
One of the biggest advantages of QDP is a package of customized marketing materials that include digital or print, social media and/or TV/radio. All available at no extra cost to you!
Affordable Dental Insurance Plans For Individuals
A brand new office plan can take years to develop and perfect. With QDP, you can get started and see results—like more new patients and increased case acceptance—immediately. QDP is truly turnkey
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