วันพฤหัสบดีที่ 9 กุมภาพันธ์ พ.ศ. 2555

Dental Insurance - HMO or PPO - What's the Difference and Which Is Better?

There are several important differences between HMO and PPO dental insurance plans. If you are trying to decide which one to go with you will want to answer several questions, the first being, does your choice of dentist matter to you? With PPO dental plans they usually have a wide network of dentists to choose from.

With HMO's you usually have a very limited number of dentists to choose from. This does not mean that HMO dental plans are inferior however because where your choice of dentist is limited, you make up for it with savings on the more major restorative procedures.

The way this works is that first off, PPO plans always have a calendar year maximum of $1,000, $1500 or $2000. That means that the insurance company will not pay claims on your behalf once you have reached this threshold.

HMO plans usually do not have any maximums, which only means that if you have extensive restorative work that needs to be done (think dental implants, inlays, onlays, multiple root canals/crowns) the savings will be substantial.

Another difference is that with HMO plans, all services are tied with copays, usually not more than $280 for the most involved procedures. With PPO plans you pay percentages which can be much more when it comes to the major restorative work.

What is the bottom line? If you don't anticipate needing extensive dental work done and just want coverage for preventative care, x-rays and fillings and choice of dentist is important to you, a PPO plan will be just fine for you. If you know that you need some more major restorative work done and choice of dentist is not so much a concern as is saving on the work that you need to have done, an HMO plan may be a better fit for you.

Dental Insurance - When Your Children Need Braces

If your kids need braces, then you probably have a few questions about the cost. How expensive are they? Would it be a good idea to invest in dental insurance or a dental discount plan to cover the braces? Are the prices negotiable? Read on for the answers.

How much do braces cost? It depends on where you live and how severe your child's case is. If you live in a more rural area, you may be able to find orthodontic treatment for less than $3000. However, if you live in the big city, the price could be up $7000 or more.

Why do braces cost so much? If you compare braces to other personal services, orthodontic treatment actually does not seem so costly. Your child will visit the orthodontist approximately 100 times during their treatment. The treatment usually costs between $3000 and $7000, therefore the cost is about $30-$70 per visit, which is just a little more than the cost of going to a beauty parlor, but less than the price of visit to the car mechanic. Orthodontics only seem expensive because of their overall price: the price of straight teeth, a beautiful smile that could last a lifetime.

Are the fees negotiable? Typically, orthodontists will not cut their fees because of the all the costs they have to pay. They must account for the cost of their equipment, materials, sterilizers, and malpractice insurance. Orthodontist offices also need to pay rent and staff salaries. Most of the fee for orthodontics goes toward paying these operating costs. Occasionally, however, an orthodontist will consider lowering his prices for patients who sincerely cannot afford to pay, but these reductions are rare. You can also ask your orthodontist about paying in installments, as many orthodontists allow this. You could also sign up for insurance to help cover the costs, or turn to an affordable discount dental plan, which can reduce the cost of braces by 20%.

Is orthodontic treatment worth the cost? Absolutely! If your child needs orthodontic treatment and does not receive it early in life, he or she will have oral problems for years in the future. As a result, many adult patients now choose to receive the orthodontic treatment they lacked when they were younger.

Common health issues due to putting off braces:

Increased chance of cardiovascular disease

Increased stomach problems due to difficult chewing

Failure to undergo palatal expansion, causing movement of the roof of the mouth to partially block air passages through the nose later in life. This problem can only be fixed with major surgery.

I absolutely cannot afford orthodontic treatment, but my child severely needs it. Are there alternatives? The EPSDT program may pay for treatment if you are on Medicaid. By law, this program can allow every low income child to be provided with dental services. There are some states that include orthodontics when it is medically necessary. Check with your state's health department about orthodontic coverage if you cannot afford braces. If not, try a dental school or a children's hospital. Often, student orthodontists will provide braces for your child for a cheap fee, though the treatment may not be the quality of a professional orthodontist.

Now that you know how to navigate orthodontic prices, you're ready to decide whether you want to use dental insurance, a dental insurance alternative like a dental discount plan, or the EPSDT program to pay for your children's braces instead of paying out-of-pocket. Whatever method you choose, remember the cost per visit is cheaper than the cost to fix your car, and aren't your children's teeth more important?