Health - Questions and Answers about Insurance
Wednesday, July 30th, 2008In this scenario, people should analyze their options well to ensure that they are able to coordinate the benefits they get under each plan. Group dental insurance provided by someone’s employer is enough to cover their dental expenses and so they don’t have to worry about buying individual dental coverage. All participating members of a company’s dental plan are covered under one policy. Because of the large number of participants, the policies provide for greater coverage at lower costs. Group insurance benefits vary from company to company depending on the plan that the employer has opted for. Not all group dental plans are the same. The basic difference between the plans lies in the option they offer for choosing a dentist. Based on this difference, dental plans can be categorized as open panel or closed panel plans. Open panel, as the name suggests, allows the employee to receive services from any dentist. This means the individual has the freedom to exercise his or her choice with regard to choosing a specialist. But this is not the case with closed panel plans wherein the employer can receive treatment from a dentist listed only in the plan’s network. Closed panel plans can be further categorized as Preferred Provider Organization (PPO) Plans and the Exclusive Provider Organization (EPO). With PPO Plans, the patients are charged less if they receive treatment from a preferred provider who is on a dentist list in the plan network. If they choose the services of a dentist not listed in the plan network, they end up paying a higher fee. EPO Plans are the most restrictive of all plans. Under this plan, the patients will receive services on reduced rates only if they choose a dentist from the network list, otherwise, charges will be not be covered by the plan. The benefits covered by each of these plans may vary, but most provide for the maintenance of good hygiene. This includes basic cleanings, fillings, and dentures. Group dental plans make economic sense to the employers. For most employees, dental coverage can be a major reason to remain faithful to the company, which can be complemented by extending coverage to the family members of the employees. Think of the word ‘health insurance’ and the idea formed in your mind is of covering serious diseases through insurance plans. Yet dental insurance, in many ways, is different from health insurance. Health insurance plans usually provide coverage for serious diseases that by their very nature can be unpredictable and catastrophic.
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