<P>13© 2009 AAPD All rights reserved. What are the different kinds of dental insurance plans available in the market? Two major types of dental insurance exist: indemnity plans and managed care plans. Dental Indemnity Plans (Fee for Service FFS) An indemnity dental insurance plan is typically administered by a third party, usually an insurance company, and pays for all or part of the dental treatment. The employee/patient has complete freedom of choice in selecting a dentist. If the patient is happy with their established dentist, changing dentists could have a negative effect on the quality or quantity of care the family receives. Because routine visits to the dentist reduce the likelihood of developing serious dental disease, its best for patients to maintain an established relationship with a trusted dentist. This type of plan also allows a patient to go directly to a specialist without a referral by a general dentist. • These dental insurance plans use a Usual, Customary, and Reasonable (UCR) fee schedule. This allows the insurance company to pay its maximum bene?t up to a preset percentage of a dentists submitted charges, the UCR. To arrive at the UCR, the dentists fee is compared to the fees that are submitted by other practicing dentists within a speci?c geographical area (usually the zip code). If the charges are higher than the plans fee schedule, then the bene?t percentage is calculated on the UCR, not the dentists actual fee. For an indemnity plan, the patients co-payment would be the difference between the bene?t and the UCR. It is important to note that exceeding the plans UCR fee does not mean that the dentist has overcharged for the procedure. There is a wide ?uctuation and lack of government regulation on how plans determine the UCR fee. Often, specialists fees are not considered separately when determining UCR fee schedules. • Insurance providers will pay up to 100 percent of preventive dental care and varying amounts for other services Direct Reimbursement (DR) Direct Reimbursement is a self-funded dental bene?ts plan that reimburses patients according to dollars spent on dental care, not type of treatment received. It allows the patient complete freedom to choose any dentist. Instead of paying monthly insurance premiums, even for employees who do not use the dentist, employers pay a percentage of actual treatments received. Moreover, employers are removed from the potential responsibility of in?uencing treatment decisions due to plan selection or sponsorship.</p> <UL><LI><a href="http://www.stallionpublishers.com/publication/1603/hvvyzehvw/1/1/">Front-Cover</a></LI> <LI><a href="http://www.stallionpublishers.com/publication/1603/hvvyzehvw/2/2/">Inside-Front-Cover</a></LI> <LI><a href="http://www.stallionpublishers.com/publication/1603/hvvyzehvw/3/3/">Page-3</a></LI> <LI><a href="http://www.stallionpublishers.com/publication/1603/hvvyzehvw/4/4/">Page-4</a></LI> <LI><a href="http://www.stallionpublishers.com/publication/1603/hvvyzehvw/5/5/">Page-5</a></LI> <LI><a href="http://www.stallionpublishers.com/publication/1603/hvvyzehvw/6/6/">Page-6</a></LI> <LI><a href="http://www.stallionpublishers.com/publication/1603/hvvyzehvw/7/7/">Page-7</a></LI> <LI><a href="http://www.stallionpublishers.com/publication/1603/hvvyzehvw/8/8/">Page-8</a></LI> <LI><a href="http://www.stallionpublishers.com/publication/1603/hvvyzehvw/9/9/">Page-9</a></LI> <LI><a href="http://www.stallionpublishers.com/publication/1603/hvvyzehvw/10/10/">Page-10</a></LI> <LI><a href="http://www.stallionpublishers.com/publication/1603/hvvyzehvw/11/11/">Page-11</a></LI> <LI><a href="http://www.stallionpublishers.com/publication/1603/hvvyzehvw/12/12/">Page-12</a></LI> <LI><a href="http://www.stallionpublishers.com/publication/1603/hvvyzehvw/13/13/">Page-13</a></LI> <LI><a href="http://www.stallionpublishers.com/publication/1603/hvvyzehvw/14/14/">Page-14</a></LI> <LI><a href="http://www.stallionpublishers.com/publication/1603/hvvyzehvw/15/15/">Page-15</a></LI> <LI><a href="http://www.stallionpublishers.com/publication/1603/hvvyzehvw/16/16/">Page-16</a></LI> <LI><a href="http://www.stallionpublishers.com/publication/1603/hvvyzehvw/17/17/">Page-17</a></LI> <LI><a href="http://www.stallionpublishers.com/publication/1603/hvvyzehvw/18/18/">Page-18</a></LI> <LI><a href="http://www.stallionpublishers.com/publication/1603/hvvyzehvw/19/19/">Page-19</a></LI> <LI><a href="http://www.stallionpublishers.com/publication/1603/hvvyzehvw/20/20/">Back-Cover</a></LI> <LI><a href="http://www.stallionpublishers.com/publications/1603/x/sitemap.xml" target="_blank">site map</a></LI> </UL>


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