Paying for dental treatment: Discount dental plans.
Discount dental plans (reduced fee-for-service dental plans) can be one source of assistance in paying for dental treatment. If you are considering the idea of the idea of joining one of these programs, here are some of the points and considerations that we would suggest that you keep in mind.
Discount dental plans should not be confused with dental insurance.
Dental discount plans are sometimes confused with dental insurance but in reality their setup is entirely different. In most cases, the company that sells one of these programs is simply acting as a referral agent, referring plan-enrolled patients to plan-member dentists. For individuals (or individual families), the benefit of joining are that it allows them access to a network of dentists who have agree to provide dental services at a discounted rate. For the participating dentist, the benefit of joining a discount dental plan is the influx of new patients it can provide. These programs are also sometimes called reduced-fee-for-service or referral dental plans.
Dental discount plans are typically unencumbered with a lot of restrictions.
Discount dental plans have a number of features that, in comparison to dental insurance, can make them attractive. For example, participating in one of these programs typically does not involve filing claim forms or forms for predetermination of benefits. In most cases there are no plan deductibles, benefit limitations, or wait-period restrictions. And in some cases, a discount dental plan may even provide allowances for cosmetic dental procedures such as bonding or veneers. As an added benefit, these programs sometimes come bundled together with discount plans associated with other health-related fields (vision, pharmacy, hearing, chiropractic).
How do discount dental plans (reduced fee-for-service dental plans) usually work?
Most dental discount plans work in the following fashion. The member pays an annual (or monthly) membership fee. It seems that this fee usually runs on the order of around one or two hundred dollars per year, depending on whether the membership is for one individual or one individual family.
The precise discount that the member receives for any particular dental procedure is determined by the plan's fee schedule. This fee schedule lists all covered dental procedures and the amount that the participating dentist is allowed to charge for each of them (as payment in full for services rendered). (The fees listed in the schedule will vary by geographical area and possibly in regards to the specific contract the company has in place with that particular participating dentist.) The member's discount is simply that difference between the plan's stipulated fee and the dentist's normal fee. (Notice that with a discount dental plan all financial transactions associated with treatment are between the patient and the dentist. The company that has sold the plan is uninvolved.)
Always remember, buyers beware.
In case you haven't noticed, the whole premise associated with a discount dental plan is that in exchange for being referred patients, the dentist will reduce their fees. That's it. The membership fee that the plan member pays stays with the program organizer and is not shared with the participating dentist. The discounted fee that is paid by the dental patient is all of the money that the dentist makes for having performed that procedure.
From this, one can only draw a few conclusions. One assumption could be that the dentist can afford to reduce their fees because the increased patient load that participating in the discount plan provides helps them to create an economy of scale that allows their office to work more efficiently and profitably. Another way of looking at things is that the discounted fee that they are allowed to charge really does represent a reasonable fee and, while not making as much as they might otherwise, the dentist can still make a suitable profit. The final scenario that we can come up with is one where the participating dentist can afford to take a loss on plan-covered dental services because they can make up these losses by way of providing (not covered) "upgrade" or "add-on" procedures and treatments.
We only mention this last item as a reminder to you that you must always evaluate any discount dental plan that you are considering with open eyes. Our next page provides specifics as to what type of plan terms and policies might be manipulated or otherwise prove to be to your disadvantage (or, on a more positive note, work to your advantage).
When it comes to comparing the financial terms of individual discount dental plans, you really need to just sit down and down do the math.
When comparing different dental discount plans, the precise degree of savings that each program offers can be a bit difficult to determine. We collected data from a half dozen plans, entered this information into a spreadsheet program and then evaluated and compared it. What we decided was that the individual procedure discounts allowed for by different discount dental plans varied enough that it was difficult to come to any broad-sweeping conclusions about which policy was best. We do, however, have a few things to say in regards to what we saw.
First, when you make comparisons between two or more reduced fee-for-service dental plans, make sure you are evaluating the plan's fee schedule that applies to your specific city and state (typically this information is ascertained by way of you providing your zip code). A plan's fee schedule absolutely varies by way of geographical region.
Second, plans seemed to fall into one of two broad groups. Those discount dental plans that offer high savings on preventive measures (cleanings, x-rays) and those that don't offer such a steep discount for these services. Those that did provide better savings on preventive services seemed to provide less of a discount on other types of dental procedures (fillings, root canals, crowns). The reverse seemed to be true for those plans requiring a higher patient payment for cleanings, exams and such.
As a way of putting this information to use, it seems that some discount dental plans might prove to be a better choice for that initial time period (first year) when the new enrollee has a significant amount of dental work that needs to be done. Later on, when just normal maintenance is expected, another (more preventive services oriented) plan might be the more cost-effective choice.
And finally, if relatively extensive dental treatment is needed and you have the luxury of knowing specifically what procedures you require, you can almost certainly save yourself at least a few dollars (probably along the line of the plan's annual fee) by just sitting down and grinding through the benefits calculations for a couple of different plans. It seems that even seemly similar discount dental plans, when closely inspected, will be found to have their own quirks and nuances.
