<P>9© 2009 AAPD All rights reserved. 2. What routine corrective treatment is covered by the dental plan? What share of the costs will be the patients? While preventive care lessens the risk of serious dental disease, additional treatment may be required to ensure optimal health. A broad range of treatment can be de?ned as routine. Most plans cover 70 percent to 80 percent of such treatment. Patients are responsible for remaining costs. 3. What major dental care is covered by the plan? Since dental bene?ts encourage the patient to obtain preventive care, which often eliminates the need for major dental work, most plans are restrictive when it comes to paying for major dental work. Most plans cover less than 50 percent of the cost of major treatment. Most plans limit the bene?ts – both in number of procedures and dollar amount – that are covered in a given year. Patients must be aware of these restrictions. Major dental care includes restorative care (gold restorations and individual crowns), oral surgery (removal of impacted teeth and complex oral surgery procedures), periodontics (treatment of complicated periodontal disease requiring surgery involving bones, underlying tissues or bone grafts), orthodontics (braces), dental implants (either surgical placement or restoration), and prosthodontics (?xed bridges, partial dentures and removable or ?xed dentures). 4. Will the plan allow referrals to specialists and is there a limitation of age for referrals? Will the patient be allowed to obtain services from a pediatric dentist or other specialist? Some plans limit referrals to specialists. The dentist may be required to refer the patient to a limited selection of specialists who have contracted with the plans third party. Also, the plan may require the patient to obtain permission from the plan administrator before being referred to a specialist and often an age limitation for referrals is included in the provisions. Before choosing a plan that has such limitations, it is important to make sure quali?ed specialists are available in the local area. Look for a plan with a broad selection of different types of specialists. Parents will most likely prefer a plan that allows a pediatric dentist to be his/her childs primary care dentist. While many general practitioners are quali?ed to perform some specialized services, complex procedures often require the skills of a pediatric dentist with special training. Patients should discuss the options with their dentist before deciding who is best quali?ed to deliver treatment. Choose a plan with no age limitations for referrals. Patients with special health care needs often exceed the typical age of child contract provisions and are denied coverage. 5. Can the patient obtain care when they need to? If an HMO plan is selected, the patients must have a clear understanding of the dentists policies as well as the plans dentist-to-patient ratio. Its the best way to ensure that access to care is not unduly restricted. </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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