Dental Health Maintenance Organization plans entail dentists contracting with a dental insurance company that dentists agree to accept an insurance fee schedule and give their customers a reduced cost for services as an In-Network Provider. Many DHMO insurance plans have little or no waiting periods and no annual maximum benefit limitations, while covering major dental work near the start of the policy period. This plan is sometimes purchased to help defray the high cost of the dental procedures. Some dental insurance plans offer free semi-annual preventative treatment. Fillings, crowns, implants, and dentures may have various limitations.
Dental insurance companies divide benefits, services, or procedures into categories and refer to them with American Dental Association (ADA) 3-4 digit code. As an example, Preventative and Diagnostic procedures often include exams (ADA code 0120), x-rays (ADA code 0210), and basic cleanings or prophylaxis (ADA code 1110). Basic procedures often include fillings, periodontics, endodontics, and oral surgery. Major procedures often are crowns, dentures, and implants. Procedures such as periodontics, endodontics, and oral surgery may be considered major, depending on the policy.
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If you are on a policy that requires you to go to a participating provider, you should not be charged the difference between these two prices. A contracted dentist generally has an agreement with the insurance company to write off the difference in charges. If the policy allows you to go to a dentist or pediatric dentist of your choice, check the insurance company’s UCR fee guide against the fees that dentist charges. You may be required to pay the difference out of your pocket, however, you cannot put a price tag on quality dental care.
AARP, Aetna, Blue Cross, Humana, and Delta Dental are a few of the many insurance companies that offer dental plans to seniors. Each company may offer more than one type of dental plan and it is important to pay close attention to more than just the cost of the dental policy. Choosing the best dental plan for a senior is a balancing act between cost, affordability, and need. A good approach is to start by understanding what the senior’s dental needs are and then make a table so that as you begin to compare the different dental plans you can narrow down those plans that are good and remove those plans that are either too costly for the coverage they provide or that do not fit the senior’s dental needs.
Some of the benefits of a Carrington dental plan are the low fees, the fact there is no waiting, and that you can choose your own dentist amongst their network. There are also no limits on your coverage and you don't have to fill out any paperwork. Some downsides are that you will likely end up paying more for your procedures than if you had one of the best dental insurance plans.
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