When you need to purchase a major appliance, do you drive to the closest home store and buy whatever looks like a good deal?

Probably not. If you’re like me, you research the brands and check the measurements to ensure the appliance will fit your space.

This same analogy applies to dental insurance. As an employer or Human Resource benefits specialist, how can you be sure the dental plan you select will be the best value for you and your employees, and that it will provide the services you need?

It helps to do some research and talk to your insurance agent. Here are some ideas on what to ask:

1. What type of plan is it?
   There are many types of dental plan choices available. The most common ones are PPOs (Participating Providing Organizations), DMHOs (Dental Managed Health Organizations), and Discount plans.
2. What are the features of the plan, and how much does the plan pay for services?
   For every dental plan, you need to evaluate the services and features provided. Make a list of the services you need and review the plan for coverage options, such as crowns, root canals, or orthodontia.
    
   • With a PPO plan, you receive a list of dentists in your area who have agreed to offer services at a set price. Each year, you pay a specific deductible amount and the plan will cover a percentage of the cost of the dental service. For example, dental checkups are usually paid at 100%; fillings may be covered at 80% of the fee; and the plan may pay 50% of the cost for crowns and root canals.
   • You have the option of using a dentist outside the network, but the plan will often pay a lower percentage for out-of-network services. You are responsible for the remainder of the bill.
   • With DMHOs you must use one of the network dentists. There is a set fee for each service the dentist provides. Unfortunately, the network of dentists is often small and there is no coverage for services provided by dentists out of the DMHO network.
   • Discount plans offer you a “discount” on services if you use a network dentist. This is not dental insurance. You need to carefully review the services and fees associated with the plan.
3. How soon can I use my benefits?
   Usually you can use the plan immediately for dental checkups. Some plans have a waiting period if you need major service, such as a crown or root canal.

What are your questions about dental insurance? Let me know and I will compile the questions and provide some answers. – Scott

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