More About Dental, Vision, and Hearing Insurance
Dental insurance works much in the same way medical insurance works. For a specific monthly rate, or “premium,” your clients are entitled to certain dental benefits, usually including regular checkups, cleanings, x-rays, and certain services required to promote general dental health. Some plans will provide broader coverage than others and some will require a greater financial contribution on your clients’ part when services are rendered. Some plans may also provide coverage for certain types of oral surgery, dental implants, or orthodontia. Vision insurance is generally a supplemental insurance to other types of medical insurance policies. Vision insurance will help offset the costs of routine checkups as well as help pay for vision corrective wear that may be prescribed by the attending physician. Please note, however, that definitions of certain terms may vary across insurance companies. Hearing insurance will cover a portion of the costs of hearing aids.
Dental, Vision, and Hearing Insurance is designed to pay a portion of the costs associated with dental, vision, or hearing care. There are several different types of individual, family, or group dental insurance plans that are grouped into three primary categories: (1) Indemnity (generally called dental insurance) that allows your clients to see a specialist of their choice who accepts this type of coverage; (2) Preferred Provider Network plans (PPO); and (3) Health Maintenance Organizations (HMO) in which your clients are either assigned to, or have the ability to select, an in-network dentist and/or in-network dental office and use the dental benefits in that network. Generally these offices have a fee schedule or a list of prices for the dental services or procedures they offer. Insurance companies have similar fee schedules which is generally based on Usual and Customary dental services, an average of fees in your clients’ areas. The fee schedule is commonly used as the transactional instrument between the insurance company, the specialist or their office, and the consumer.
Indemnity Insurance Plan—This plan may be helpful when your clients want to stay with their dentist and he/she does not participate in a network. By the very nature of this plan, the insurance company generally pays a percentage of services according to the policy purchased. In addition, your clients will want to review the copayment requirements, waiting periods, stated deductible, annual limitations, graduated percentage scales based on the type of procedure, and/or length of time they have owned the policy prior to starting your procedure.