Dental insurance is a kind of insurance which has been designed so as to cover the costs which are associated with the dental care. There are various kinds of dental insurance plans like for an individual, group or family. Each of them has its own benefits and one must choose the one which suits their needs the best.
All the plans vary greatly and you must be aware as to how your plan has been designed. It is because that can affect the coverage of the plan significantly. All the features of the plan differ but most of the designs can be grouped into the following.
Customary and Reasonable (UCR) programs
These generally give the right to the patient to visit the dentist that they prefer. The blue cross blue shield dental insurance also offers this feature which is much favored by people. These plans only pay a determined percentage of the fee of the dentist or the plan administrator’s customary or reasonable fee limit according to whichever is less. These limits are actually the result of the contract between the third party payer and the purchaser of the plan.
Direct Reimbursement programs
These are the programs wherein the patients have reimbursed a percentage which has been predetermined of the total amount spent on the dental treatment. This program would not exclude the coverage which is based on the kind of treatment required and also allows the patients to visit the dentist of their preference. This program also offers incentives to the patients for cooperating with the dentist for solutions that are economically sound.
The capitation programs pay the contracted dentists an amount which is fixed usually on a monthly basis for each of the enrolled family or patient. In return, the dentist has to agree to offer certain kinds of treatment to the individuals at absolutely no charge. For some of the treatments, the patient might have to co-pay. The premium of the capitation program which is paid might differ largely from the amount which the plan offers for the actual dental treatment of the patient.
Table or Schedule of Allowance Programs
The Table or Schedule of Allowance programs ascertains the list of services that would be covered by the insurance with a determined amount. The amount that has been determined represents as to how much the plan would actually pay for the services that have been covered despite the fees that would be charged by the dentist. The difference between the fee of the dentist and the allowed charge would be billed to the patient. This means that the patient would have to pay for it.
The blue cross blue shield dental insurance also might group the dental insurance into the above-listed categories. However, before getting insurance, it is important to consider all the terms and the conditions of the insurance. Several factors like the predetermination of the costs and the limitations of the benefits annually should be considered carefully. This would ensure that you get the insurance of your choice at the best possible rate.