Dental Insurance Categories

There are four main categories of dental insurance:

• Indemnity
• P.P.O. (preferred provider organization)
• H.M.O. (health maintenance organization)
• Direct Reimbursement (self -insured)

Both a Direct Reimbursement program and an Indemnity plan recommended and endorsed by dentist.net allow you to see the dentist of your choice without any restrictions. A Preferred Provider Organization otherwise known as a P.P.O. is a financial agreement between the insurance company and the dentist, whereby the dentist agrees to lower his fees to meet a prescribed fee schedule administered by the dental insurance company and sold to your employer for a reduced insurance premium. You are given a list of providers who honor the P.P.O. program. Most patients assume that you must see a provider on the list only and this is NOT true. What insurance companies fail to convey, is that you can still visit the dentist of your choice BUT it will cost you more as a non P.P.O. dentist has not signed your insurance companies reduced fee contract.

Also known as Capitation plans, H.M.O's are generally programs, by which you, as a patient pay little or nothing out of pocket for your dental needs. Your dentist, chosen off a list, is reimbursed monthly at a small flat rate per patient. This money is received even if the patient does not come in or has no treatment done. You must leave the dentist with whom you have established a relationship and choose a new dentist from a list supplied by your employer. Unlike a P.P.O. plan, you can only visit dentists who have contracted with the H.M.O.

Dentist.net believes that these programs are based on a principle where the dentist is placed in a financially advantageous position if he or she performs little or compromised treatment on a patient. Furthermore, the dentist benefits to an even greater degree if the patient never comes in at all. Here are some paraphrased excerpts from a Dental Association newsletter sharing the Association President's views on these plans:

" I finally concluded…. it is extraordinarily difficult to maintain quality, honesty, and consistency and still make a living with these programs. In order to break even with these programs, you must: discourage treatment of early cavities, downgrade the classification of periodontal disease, extend amalgam fillings to more surfaces than the cavity calls for, not schedule recall visits, allow appointments only during the least desirable times, and basically do as little as possible. What good will I be if I skimp on quality, intentionally under-diagnose, and operate dishonestly?"

Dentist.net Dentists encourage regular preventative visits and optimum treatment. We feel that we take the necessary time that each patient requires to get them to the best state of oral health while maintaining a friendly, relaxed, and most of all, personal atmosphere. We truly care for every single patient, and your continued feedback, compliments, and referral of friends and family always make us proud. We strive to provide you with top quality comprehensive care at a reasonable fee. It is unfortunate that many of these cost cutting insurance plans cannot allow us to do so.

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