Dental Insurance is a tool to minimize the expenses on the dental treatment and remedies. Insurance providers pay on behalf of the patient to the consultants. North Carolina is full of reputed dental insurance companies which offer individual, family and group medical dental cover at very affordable prices.Cashless, Copayment and fee for service facilities are availed and enjoyed by the patients with a number of dentists and hospitals for numerous dental services and surgeries also.
Dental insurance in North Carolina also works like other places and gives fee based service and managed for care options. In the former the user prefers to pay upfront and present for the cover later with the relevant proofs. In this case the insurance provider will analyze and review the claim and reimburse with the permissible limits. On the other hand, in the managed care plans the customer has a variety of dentists available in the network. By paying advance premiums one can get the treatments as and when required. Here less documentation is involved and service rendering is also seamless and hassle free. With this flexibility the user gets the freedom and tension free dental life.
There are many dental insurance plans available with distinct benefits. Let us look at them in details:
1. Preferred Provider Organization (PPO) Plan: In PPO plans the insurance company has an exhaustive list of participating preferred dentists. These consultants agree to receive fixed fees and offer the predefined treatments and consultation to the patients. Here the cost incurred to the user gets controlled. Against certain periodic premiums the preferred providers offer services at a discounted rate. The insured has the flexibility of choosing the out networks medical practitioners also but in that case the dental cover is upto certain limit only and surplus expenses is borne by the policy holder only.
2. Indemnity Insurance Plan: This plan offers greater range of hospitals and dentists with some pre approved limit and procedures. It is done on the basis of UCR index, which signifies usual, customary and reasonable. It includes the cost that is agreed between the dentist and the insurance service provider. The purchaser must check with the fee schedule and updating cycle of the dental insurance.
3. Discount Dental Plan: It offers a low cost dental cover and generally preferred by the patients who do not have sufficient dental cover. Here the customers need to pay monthly or annual low premiums and he can avail many services related to dental disorders and diseases. One should be very clear about the fee schedule and the turnaround time for various services. One major feature is that insurer does not entertain any after claim reimbursement and only specified treatments are covered.
4. Dental Health Maintenance Organization (DHMO) Plan:DHMO is systematic and organized dental insurance plan where a big network of dentists and consultants operate to provide a wide array of services to the patients. Fix payments and fees are given to the participating parties and users also pay a nominal premium or sometime zero premium. Copayment is a very normal scenario with DHMO dental plans.
5. Fee Schedule Plan:In such plans dentists decide a fee schedule for the services in advance and the plan works accordingly. The patient can opt for upfront payment followed by the reimbursement claim or can pay in advance and receive the services in lieu of that. Many customers opt for this plan as per their need and want.
Patriot Health Inc.
Security Life Insurance Company