Dental insurance

TYBBI SEM-VI DENTAL INSURANCE
. INTRODUCTION TO DENTAL INSURANCE
As we know that poor care of mouth and teeth can affect a
person general health and well being throughout his life.
Generally, when this problem comes, there is a need to start
seeing a dentist regularly…and everyone knows a hole in tooth
can put a bigger hole in wallet…that costs money!
Because dental disease is so common, being protected by dental
insurance and using it wisely is essential safeguards for any
individual or a family.
Among other insurances “Dental insurance” is rather unique.
First, its low cost makes dental insurance highly affordable for
individuals and families. Second, because dental insurance
encourages and generally pays for regular check-ups, many
people who purchase protection start to benefit immediately.
Dental plans usually cover a wide range of services. These
include preventive care, emergency care, and procedures such as
crowns, root canals, periodontics, orthodontics, oral surgery, and
more.
KES SHROFF COLLEGE OF ARTS& COMMERCE 1

(a) Traditional Dental Insurance: -
Dental insurance is sometimes attached to healthcare packages
that accompany jobs at larger companies. However, more often
these days, dental and vision is not part of company health
packages. This means that it is up to the individual to get his or
her own coverage.
(b)
(c) Preventative Dental Care: -
Of course, once a person has dental insurance he has to make
sure that he visits the dentist on a regular (twice a year) basis!
Still, if a person is paying even the most affordable premiums it
is another incentive to make sure that he gets the preventive
work done. It will really cut down the chances of having major
and costly work done in the future.
Dental plans have always been an utmost necessity. Even for the
most frugal or fearful person, tooth and gum problems are hard
to ignore. A person rely on his teeth and gums every time he eat

or drink, so there is nothing more miserable than having dental
problems that go untreated.
In today's uncertain economic times, however, finding
affordable dental care has become quite a challenge. Fewer
people than ever have insurance and even fewer have dental
insurance. This is because of the prohibitive cost of most
traditional dental insurance plans.
WHY IT IS NEEDED?
Why is dental insurance needed? Well, the most important reason is of
course that treating dental problems is expensive. Second reason is that
dental diseases are so common and yet preventable those with a dental
insurance cover that stresses on preventive care we can enjoy trouble free
oral health.
Almost every member of the family needs to visit a dentist for routine
check-ups every year. Many times it's more frequent that that. With out
dental insurance we should be prepared to pay for these costs.
But having a family dental insurance cover will protect one family by
covering the costs of our dental care. It's an essential safeguard for one
family's dental health.
Preventive care, including regular checkups and cleanings, is very
important to maintain good dental health. With regular visits to the
dentist, problems can be diagnosed early and treated without extensive

testing or elaborate and expensive procedures. That is why dental care
costs are much lower when compared to medical care.
A good dental insurance cover is an ideal safety to help us keep medical
and dental costs under control. So, invest wisely and choose a dental
insurance plan that meets family needs. A variety of online dental
insurance plans is now available and is quite simple to buy too.

3. DENTAL PLANS
Dental plans and programs offered by many are not health insurance
policies. They provide discounts at certain health care providers for
medical services. Some of the Dental Plans providers do not make
payments directly to the providers of medical services. The Plan or
Program member is obligated to pay for all health care services but will
receive a discount from those health care providers who are in contract
with the plan organization.
Each insurance company has different types of dental plans. It is
impossible to generalize the types of plans because what works for one
company doesn’t work for another for reasons of different types of
employers. But there are some common features that can be noticed in
most dental plans.
Fee-for-service plan is a quite common plan (or the variation of it). Many
discount dental plan offer savings of certain percentage on most dental
procedures. When visiting a participating dental provider, a patient will
be charged according to the plan discounted schedule fee. With fee-for-
service plan a patient may visit any licensed dentist and change dentists at
any time without notifying their insurance company. Sometimes these
costs may be lower if a person visiting a dentist that is a dentist sponsored
by a particular insurance company.
A variation of fee-for-service plan works almost in the same way where a
dentist is paid for each service provided and the patient may be
responsible for a deductible or co-payment for certain services as well as

amounts above annual maximum. While the patient may visit any
licensed dentist and change dentists at any time without notifying his
insurance company, he will maximize his benefits when visiting a dentist
specified by his insurance company. An insurance company will pay its
portion directly to the dentist to make things easier for him. A patient will
most likely get a notice explaining his portion of the bill, and than will
pay the dentist only that amount that is specified on the bill.
• Choosing a dental plan
When looking for an appropriate dental benefits plan, it is important to do
the research and make a knowledgeable decision. It is a good idea to
contact several different insurance carriers and spend time asking
questions and comparing packages.
Most dental coverage tries to ensure people can receive regular
preventive care. Choosing the right dental plan can help to save a lot of
money over the course of one year or several years. A person should be
sure to take advantage of easy-to-use plan comparison chart to compare
the savings and features of each discount dental plan in his area before
deciding on a plan that is best for him.
Contrary to many medical ailments, dental problems are generally
preventable. Through preventive care such as good dental hygiene,
regular checkups and teeth cleanings, problems can be diagnosed early
and treated without extensive testing. Therefore, the cost of dental
insurance is usually lower than that of medical insurance.

• Routine treatments covered by the dental plan
Check to see how much will have to pay out of pocket alongside the
dental coverage. There is a broad range of treatments considered routine,
and one can obtain a list of these from different dental insurance carriers.
• Major dental or emergency care is covered by the plan
Not only one want to know what major care is covered, but one should
also ask the amount of co-pay (money out of pocket). Dental plans are
often not as generous with major dental care or emergency coverage since
their focus is largely on preventive treatment.
Section I.2 PREVENTION IS BETTER
THAN CURE
We can find that Dental plans emphasize prevention whereas medical
insurance is designed to cover the costs of serious illnesses. Why do
dental plans emphasize prevention?
Simple it's because dental diseases are preventable. Dental problems do
not require elaborate testing and complex equipment. Usually all it needs
is an examination by a dentist and some X-rays to diagnose most dental
ailments. Dental plans works quite differently from medical insurance.
Most dental plans are designed so that patients receive regular preventive
care. High quality dental care rarely requires the complex, multiple
resources often required by medical care. As dental problems are
preventable, dental benefits plans are structured to encourage patients to

get the regular, routine care that is important in preventing the onset of
serious dental ailments.
Now days we can notice that dental plans emphasize that we assume
more costs for dental treatment than for preventive care. Yes, it is much
cheaper and safer to prevent dental disease than to cure it. In fact statistics
show that preventive care saved nearly 100 billion dollars for America in
the 80's.
Choose wisely choose dental plans that offer preventive care. It's
definitely cheaper for us in the long term. Dental plans offer a
comprehensive dental insurance cover with an emphasis on preventive
care.
THE THIRD PARTY IN INDIVIDUAL
DENTAL PLAN
In any individual dental plan, there are usually three parties:
1. We, the patient
2. The dentist providing care
3. And a third party with whom our employer or we contracts for
coverage.
The primary responsibility of the third party is to provide the financial
foundation for our individual dental plan. There are three types of third
parties in any individual dental plan.
Dental Service Corporations: These are the not-for-profit organizations
that negotiate and administer contracts for individual dental plan plans or
specific groups of patients. Delta Dental Plan and Blue Cross/Blue Shield
Plans are examples of this third party type.

Insurance Carriers: These are the for-profit companies who underwrite
the financial risk of, and process payment claims for, dental services.
Carriers contract with individual dental plan seekers or patient groups to
offer a variety of dental benefits packages, often including both fee-for-
service and managed care plans.
Self-Funded Insurers: These companies use their own funds to
underwrite the expense of providing dental care to their employees. The
company pays for the dental costs of its employees, usually with
limitations on services and fixed-dollar allocations.
Being informed and selecting an individual dental plan suited for our
needs is the wisest decision that we can take in the management of our
dental health.
SMALL BUSINESS DENTAL PLAN
If we own a small business and would like to offer dental cover for our
employees we could get group dental plans. We get discounts for group
cover and all our employees and our self can benefit from the lower costs
for membership. The small business dental plans can also be tailored to
suit the needs of our employees.
Dental insurance cover is available only to those Americans whose
employers offer the dental cover as part of medical insurance cover. The
rest have to do with dental discount plans. The small business dental
plans are a real boon to small employers and their employees who would
otherwise have no dental cover.
Dental treatment is expensive if dental problems are detected late. The
sooner they are treated the lesser the cost. Best of all is to prevent dental
problems. As an employer we should tailor our small business dental plan
emphasizing on prevention. Regular check-ups, dental cleanings and

routine visits to the dentist should all be part of the small business dental
plan.
A group small business dental plan is the best bet against dental
emergencies. As a small business owner even the loss of few man-days
can cause serious disruptions in our schedule and loss of long-term
customer trust if we do not deliver on time. A few dollars invested in a
small business dental plan can potentially save us thousands of dollars.
So do not hesitate to invest in-group small business dental plan and
what's more we can avail of discounts too on the membership fees.

4. DENTAL INSURANCE PLAN
Dental insurance plan models are changing from traditional dental
insurance to latest dental insurance plans. In traditional dental insurance
plans, first we pay a premium, usually every month. Then we have to
meet the deductible. Then, and only then, we can count on the insurance
company paying for our care or can we.
People get fed up with the rules of traditional dental insurance plans. But
now days of traditional dental insurance are over. There are alternatives
to the costly premiums and deductibles of insurance companies. This is
the fee-for-services plan.
Like health insurance plans, dental insurance plans are usually
categorized as either Indemnity or managed-care plans. The major
difference between these two concerned are choice of dental care
providers, out-of-pocket costs and how bills are paid. Typically,
Indemnity plans offer a broader selection of dental care providers than
managed-care plans. Indemnity plans pay their share of the costs for
covered services only after they receive a bill (which means that we may
have to pay up front and then obtain reimbursement from our insurance
company). Managed-care plans typically maintain dental provider
networks.
Although there is no one "best" dental insurance plan, some plans may
work better for us and our family than others. When reviewing our dental
insurance options, here are a few questions we need to ask our self:
• How much will dental insurance plan cost on a monthly basis?
• Which dentists participate in the dental insurance plan's network?
• Is there waiting period for certain procedures?

• If I used a dentist outside the dental insurance plan's network, how
much will I have to pay?
INDIVIDUAL DENTAL INSURANCE
Today, many people are looking at individual dental insurance schemes.
Traditional individual dental insurance is often believed to be the best
way to pay for dental expenses. And while individual dental insurance is
a good option when sponsored by our employer, it is often not very cost
effective when paying for it our self. Most individual dental insurance
plans require us to meet waiting periods and deductibles before having
major and sometimes even minor restorative work done. Here at
Individual Dental Insurance we can shop for the best dental coverage that
protects us at reasonable prices. Dental expenses like x-rays,
orthodontics, oral surgery, are some major considerations when shopping
for a good dental program.
Individual dental insurance doesn't have to break our bank. Many people
make the serious mistake of putting off or utterly ignoring their dental
care because they're afraid it will cost too much. However, today there
are many affordable dental plans available to suit any budget.
Sometimes we have lots of questions in our mind for individual dental
insurance, like, what is the best dental solution for our individual needs?
Which company will provide us with the best rates and coverage on a
dental plan? Should we buy a dental discount card or a full dental

insurance plan? In this condition, The Dental Club is appropriate
solution. Dental clubs are always helpful like,
• To give us immediate and predictable discounts without any limits
on savings.
• The Dental Club can save us money when compared to a typical
individual dental insurance plan.
The new model for individual dental insurance is "pay as you go" without
the usual high prices. For a monthly fee, a person will receive access to a
network of reputable dentists who, in turn offer their services at
discounted rates.
1) CHILD DENTAL INSURANCE
There are a number of different dental insurance programs to choose
from, and selecting the Child dental insurance to suit our needs can be
challenging. There are discount plans, traditional plans, Dental Health
Maintenance Organizations, and sub-categories within this list. How to
know where to start?
Begin by deciding the type of coverage we need. Child dental insurance
is most often an extension of our health insurance plan. Whatever we
choose should be compatible with our medical insurance without
overlapping the coverage. There is no need to be pay twice for the same
thing.
On the other hand, make sure that our Child dental coverage provides us
with all the features we'll need. Most plans take care of routine visits and

cleanings, but some are more comprehensive than others. We'll pay more
for increased services, but if this is something that we want and will use,
the added costs may be well worthwhile.
Decide whether we want a deeply discounted plan that will allow us to
receive dental services from anyone within that network, or if we are
more comfortable visiting our own dentist each time. Discount plans
may be a cheaper form of Child dental insurance in some instances, and
may make sense for those who travel frequently or need access to a
dentist often.
Routine visits to the dentist are the most cost effective way to keep dental
payments low. Our dentist is then able to do an oral examination and
assess any potential problems early enough to correct them. It has been
shown that those people who have Child dental insurance go to the
dentist more often and have better oral hygiene.
Child dental insurance is all about receiving preventive care. In fact, the
cost of dental care has continued to fall over the past decades. In 1970,
6.3 percent of total health care costs were devoted to dental care, while in
1991; only 4.9 percent was being spent. As more and more people
practice good dental habits, the costs of care decline.
The entire focus of Child dental insurance is on preventing dental
problems and disease. It requires the patient to take responsibility for
their dental practices, such as correct brushing and flossing to maintain
healthy gums and good teeth. This type of insurance is designed to cost
the patient less to prevent the problem than to fix it, providing some built-
in incentive to develop good dental habits.
Some don't consider discounted dental plans to be dental insurance, and
strictly speaking, they aren't. There are no claim forms or waiting
periods, no maximums, no deductibles, and no limits on how often we

can visit the dentist. The monthly costs are also quite low, in most cases.
These plans can also be reasonably flexible as far the dental service
provider, allowing us to use any dentist who is part of the program. For
many people, then, this is the ideal Child dental insurance.
FAMILY DENTAL INSURANCE
Family dental insurance is one of the most popular supplemental options
for overall medical insurance policies. It's an inexpensive way to provide
comprehensive coverage for our entire family. Just having medical
coverage isn't enough, especially if we have children. All too often they
need orthodontics or have special requirements to ensure that their teeth
grow straight and strong.
In fact, pediatric dentistry may be an option, even if we are enrolling in a
Dental Health Maintenance Organization. It's a good idea to start
children off right with an appreciation of their teeth and the tools to take
care of them. Most dental disease is preventable, and it requires so little
effort to have a clean, healthy mouth. Having family dental insurance is a
great way to ensure that everyone's teeth and gums get the attention they
deserve.
Children also learn by example, and if they see that parents are brushing
and flossing regularly, they will want to do the same. Family dental

insurance shows that we care about the quality of our family's total health
care. Supplementing a medical policy will provide overall coverage that
otherwise would be excluded.
Going to the dentist on a regular basis is more likely if the fees are
covered by our insurance plan. Paying for individual family members
can get costly, and this can be offset by family dental insurance.
Discount plans allow us to get a deeply reduced rate as part of the
network. There are a variety of membership plans, but the basic idea is to
provide covered services at a reduced rate for anyone who is part of that
network.
The advantage to this type of family dental insurance is obvious for those
who travel frequently. Should an emergency arise in a location far from
home, reliable dental services would be available. There is also usually
no paperwork to complete, no waiting period, and no deductible to meet.
All a member needs to do is present their cards as proof of enrollment,
and they are eligible to receive services.
With traditional family dental insurance, there will be deductibles to
consider, and less overall flexibility in many of the plans. However, the
customer can visit their dentist of choice (although some plans also
require the dentist to be a member of the network). This insurance tends
to pay for the more expensive treatments up to the limits of the plan once
any deductible has been met.
With lots of choices available, it is important to consider exactly what
type of coverage would best suit our family. Take the lead from the type
of health insurance we've purchased, if that's a product we've been happy
with. For example, if we have and are pleased with a medical Health
Maintenance Organization (HMO), a Dental Health Maintenance

Organization is certainly worth consideration. But if our comfort level
runs toward traditional medical insurance or the deeply discounted plans,
perhaps our family would be best served with more conventional family
dental insurance.
CHEAP DENTAL INSURANCE
The need for cheap dental insurance: Good oral hygiene is a pre-
requisite to maintain a healthy life style, as symptoms of various diseases
like diabetes, heart attack, strokes, bone loss, oral cancer etc can be
detected by regular dental screenings.
The need for cheap dental insurance is growing rapidly as maintaining
good dental health is expensive. We can avoid costly dental procedures
that result from poor oral hygiene and hence save lot of money in the long
run with even a cheap dental insurance.
Regular dental cleaning and check up needs to be done at least twice a
year. People who are more prone to oral diseases should have cleaning
and check up more than twice a year.
Cheap dental insurance will be one of the best supplements for a major
medical policy. If we already have some type of medical insurance
coverage, a cheap dental insurance plan may be all that's needed. But
before we buy it, be certain about what we're getting - and that this will
meet our needs. It would be unfortunate to buy a dental plan and then,
when we need it, learn that the coverage we expected just isn't there. It is
important that we read the fine print in our policy document to learn
about any limitations and exclusions.

It is regular medical and dental insurance policy to exclude existing
conditions so disclose this to our insurance company before we make our
purchase else we will be penalized and may have to pay larger premiums
or completely.
Discount dental plans, which strictly speaking aren't insurance but take
the place of it, have become popular over the past few years, and there are
plenty of programs from which to choose that truly offer cheap dental
insurance. These plans are membership programs and require using
dental services within a network. That network may be large or small,
local or national and our choice should be based upon our lifestyle. For
someone who doesn't travel beyond his or her state, becoming part of a
national network is unnecessary (and possibly more expensive).
An advantage to using a discount plan for our cheap dental insurance is
that there are no deductibles to meet and no paperwork to fill out.
Usually, there is no waiting period. Dental services are discounted for
those that are part of the network, and fees are established for each
service. Dentists who join as part of the network have agreed to discount
their fees and can only charge what has been negotiated under the terms
of the policy. There are no surprises when it comes time to pay. We
know in advance what the scheduled fees are for each procedure
performed.
Examine the subtle and not-so-subtle differences to find a cost effective
option that meets our budget. Remember, the cheaper the insurance, the
less features and flexibility that plan will offer. At the very least, the
policy should cover basic preventive care. This means two cleanings and
oral examinations a year as well as routine x-rays. It could also include
getting teeth filled, or even more extensive dental work. Even with cheap
dental insurance, policies will vary in what is offered, so it pays to check

different types of programs to be certain the one we select suits our
situation.
Remember, too, that there is a difference between cheap dental insurance
and cost-effective dental insurance. Dental insurance becomes cost-
effective when we get the type of policy that fits our needs. By getting
routine check-ups that prevent potential problems due to neglect; we've
saved money in the long run. However, even if we don't pay a lot, if our
insurance is ignored (and figures have shown that 40% of dental
insurance in the U.S. goes unused) it can be very expensive.
MEDICAL AND GROUP DENTAL
INSURANCE
If we are considering purchasing or already have medical insura
nce, a Group Dental Insurance plan should not be far
behind. Why? Because medical and Group Dental Insurance go
together. They supplement each other and provide comprehensive
coverage in case of accident or injury.
The good news about dental coverage is that it tends to be quite
inexpensive and very cost effective when used. Group Dental Insurance
is all about preventing problems that could arise through poor hygiene
and sloppy care. Routine visits to the dentist are scheduled to detect most
of the diseases and correctible conditions that might occur. Medical
insurance is designed to cover diagnosis, treatment, and cure of serious

illness and similar situations that arise. So with the combination of
medical and Group Dental Insurance, there is complete protection.
Or is there? That depends upon the type of medical and Group Dental
Insurance we choose. Plans range from the most comprehensive to
discount fee-for-service. Because there's such a wide range to select
from, finding the one that's going to meet our needs may not be as simple
as we expect.
Whatever we decide to go with, is certain that our medical and Group
Dental Insurance plans are compatible. We don't want to be pay for
overlapping coverage, but we also don't want gaps in our coverage,
either. One should pick up where the other leaves off.
We should be able to find medical and Group Dental Insurance plans that
are written specifically for our location or state. If not, there are national
companies that offer this type of protection. We want to purchase from a
company with a solid reputation and that can provide service to our local
area.
There are national companies that specialize in writing medical and
Group Dental Insurance policies for certain states. Frequently, the same
company can write both plans. Some offer the service of signing up
online. Before doing this, we may want to speak with an actual
representative to be sure that we are getting the correct coverage for our
situation.
Choosing the optimum medical and Group Dental Insurance plan does
take some effort and investigation, but remember why we are making that
purchase. This is our safety net against catastrophic bills should a
medical or dental accident or emergency occur. It is also to prevent
conditions that could easily be diagnosed and treated before a major
problem develops.

Everyone in the U.S. needs medical and Group Dental Insurance. It's not
an option but a necessity. There are too many times when people are
underinsured and realize that in the long run, it would have been far
cheaper to have the appropriate medical and Group Dental Insurance.
(b)
(c) DISCOUNT DENTAL INSURANCE
How discount dental insurance is different from traditional dental
insurance: discount plans are different from traditional dental insurance in
several ways. First, Discount Dental Plans are easy to enroll in by
removing the hassles and waiting periods associated with traditional
Dental Insurance.
Also, unlike traditional Dental Insurance, discount plans do not deny
coverage based on patient pre-existing dental conditions. Another nice
feature of Discount Dental Plan is there is no complicated claim forms
required for usage. In addition, there are no insurance Deductibles or
Disputes to worry about. Most importantly, there is no annual maximum
benefit – we can use the plan as much and as often as needed.
How discount dental plan are similar to dental insurance: The network of
providers that participate in the Dental Discount plans are licensed

professionals just like we would find on most traditional Dental Insurance
Plans.
Discount Dental Plans are not Dental Insurance. Most “Dental Insurance
Plans” are designed for large groups, organization, or businesses.
Discount Dental Plans are an innovative alternative to Dental Insurance,
designed to suit the needs of individuals and families looking to save
money on Dental Care.
Typically, Dental Insurance is difficult to obtain unless provided by our
workplace or employer. Discount Dental Plans have stepped in to save
people money that would not be able to acquire traditional Dental
Insurance.

5. DIFFERENCE BETWEEN DENTAL PLAN AND
DENTAL INSURANCE
Dental insurance is simply an agreement between the dental
insurance company and us that will allocate us to get pleasure from
discounts on dental expenses.
Maybe we will think that dental insurance and dental plan are just one
and the same, but we are wrong. There is big difference between the two.
First let us understand what a dental plan is. A dental plan is simply the
agreement between us and the company that will provide the plan for us.
Just like dental insurance, it is a plan that will also give us discounts on
all our dental costs. They will also let us choose the doctor that we like
from the lists and the process of the approval is so easy. One good thing
about dental plans is that if we want to decrease our dental costs without
filling out so many documents, then this one is the right for us.
Are we still a bit confused about the difference between the two? There
are more ways wherein a dental plan is dissimilar from dental insurance.
• With dental insurance, we need to accomplish tons of application
forms, and not only that, because we still need to convince them
that we are free from any dental problems in the present that can
affect our dental care in the future. Which is exactly opposite if we
apply for a dental plan. Worry free when it comes to documents
because the process is very simple.
• With dental insurance, they may still require us to undergo dental
examination in order to qualify and we still have to wait for a long
period of time. While in dental plan, we just have to apply and pay
a certain amount of money for our membership and that’s it. Once

they accept our application, we may already enjoy getting
discounts on our dental care expenses.
• With dental insurance, most of the time procedures that will make
our teeth look good is not covered like, teeth whitening, braces and
many more. On the other hand, with some dental plans, we may be
eligible for treatments of pre-existing situation. Both dental
insurance and dental plans cover cleaning of teeth, root canals and
other dental care.
In getting our claims, there is also a big difference, with dental insurance;
first, we have to fill out a form that will be given to the doctor or to the
dental insurance company for approval which means that we will wait in
order to find out if our money will be reimbursed for the dental expenses.
Sometimes dental insurance companies will only give us back a small
percentage of the money we incurred for our dental care. While with a
dental plan, we will just simply show our membership card and policy
number to our dentist and he will be the one who will do all the
paperwork for us and we will be able to get the discount immediately. In
that way, we just have to pay our lowered dental expenses straight to our
dentist.
If we have money, buy one that’s worth our money. But unfortunately
there are some people who can’t really afford them. We can always find
the best and affordable dental insurance for our self. A lot of insurance
companies claim that they are the best because they are offering the best
dental care package, the best discount dental plans and a lot more. We
must be aware that dental insurance can be as intricate as other kind of
insurance. We have to be smart in choosing them.

Dental insurance Quote:
Dental insurance quotes are far more reasonably priced than medical, and
we all realize that paying for any insurance leaves no possibility for the
disasters of not having coverage when the unforeseen occurs. While the
costs of dental services are rising, employers are cutting dental benefits
out of their employee insurance plans. But it can more frequent access to
appropriate care when it is needed.
Dental Insurance Quotes:
Unfortunately, many people are not aware of all of the options they have
when it comes to gaining access to reasonably priced dental care. For
those caught in the middle (those who are not covered by an employer's
insurance, who cannot afford to pay cash, or who do not have access to
whatever public funds are available), there are now dental insurance
quotes that can help. Major insurance companies have created dental care
networks, some of which are available nationwide.
Getting Dental Insurance Quotes:
There are many sources through which we can get information on
different dental insurance quotes, including individual plan, discount
plans, and supplemental dental insurance. Whether we request a quote
over the phone, in an office, or on one of the myriad of dental insurance
websites, be sure to be informed on exactly what we want from our plan.
In this way, our quote will be as accurate as possible, with no surprises in
our first bill.
One easy way to get information on dental insurance plans and discounts
is to get our Dental insurance quote over the internet, from the comfort of
our home or office. Simply fill out an electronic form, and the company

will reply to us with an offer. Since it's this simple to get an dental
insurance quote, there's no reason we can't shop around to find the right,
affordable, practical plan for us.

6. DENTAL INSURANCE PROVIDER
For Dental Insurance there is still a network of Dental insurance
providers that have agreed to provide dental services to a healthy dental
care for people at discounted costs.
There are the three top reasons that people are turning away from
traditional dental insurance and turning toward dental savings plans,
Affordability, convenience and third important one is thousands of high-
quality nationwide Dental insurance providers.
To achieve the highest quality and most financially responsible dental
insurance benefits the dental insurance provider should be reliable.
People buy dental insurance for a variety of reasons and a good Dental
insurance provider is one who provides following facilities to them.
• Dental insurance provider, one who pays For Costly
Care,
Dental care can be a simple cleaning and x-rays. Or, it can
involve costly care from orthodontics to crowns and oral
surgery. Dental insurance generally pays all or a percentage of
the charges related to our dental care.
• Dental insurance provider, one who maintains a Healthy
Mouth,
Studies show that regular dental check-ups and cleanings help
maintain a healthy mouth. That's why most insurance plans pay

100% for check-ups every six (6) months. Some will even cover
(pay for) a check-up immediately after we are approved for
coverage.
Dental insurance provider, one who protects our Children,
from cavities to braces, younger family members will benefit from
regular professional dental care. Dental insurance can be a very
affordable way to protect against the cost of regular check-ups. Our plan
may even pay for more costly care even braces.

7. LIMITATIONS OF DENTAL PLAN
Today’s health insurance, including our dental plan, is designed to help to
get the care we need at a reasonable cost. Because each person’s oral
health is different, costs can vary widely. To control dental treatment
costs, most plans will limit the amount of care we can receive in a given
year. This is done by placing a dollar “cap” or limit on the amount of
benefits we can receive or by restricting the number or type of services
that are covered. Some plans may totally exclude certain services or
treatment to lower costs. Know specifically what services our plan covers
and excludes.
There are, however, certain limitations and exclusions in most dental
benefits plans that are designed to keep dentistry’s costs from going up
without penalizing the patient. All plans exclude experimental procedures
and services not performed by or under the supervision of the dentist, but
there may be some obvious exclusion. Sometimes dental coverage and
health insurance may overlap. Read and understand the conditions of our
dental plan. Exclusions in our dental plan may be covered by our medical
insurance.
The California Dental Association encourages consumers to choose plans
that impose dollar or service limitations, rather than those that exclude

categories of service. By doing so, we can receive the care that’s best for
us and actively participate with the dentist in the development of
treatment plans that give the most and highest quality care.
To help us stretch each dental benefit dollar, most plans provide patients
and purchasers with special administrative services. Find out if plan
provides the following mechanism to help our budget, analyze, and
dispute, if necessary, the costs of our dental care.
1. PREDETERMINATION OF COSTS:
Some plans encourage us or our dentists to submit a treatment proposal to
the plan administrator before receiving treatment. After review the plan
administrator may determine the patient’s eligibility, the eligilibility
period, services covered, the patients required co-payment and the
maximum limitation. Some plans require predetermination for treatment
exceeding a special dollar amount. This process is also known as
preauthorization, precertification, pretreatment review or prior
authorization.
Although our dental benefit plan may not be bound to predetermine costs,
this mechanism can help our dentist plan and us and budget a treatment
plan appropriates to our oral health needs.
2. ANNUAL BENEFITS LIMITATIONS:
To help certain costs, our plan may limit our benefits by number of
procedures and / or dollar amount in a given year. In most cases,
particularly if we have been getting regular preventive care, these

limitations allow for adequate coverage. By knowing in advance what
and how much our plan allows, we and our dentist can plan treatment that
will minimize out – of – pocket expenses while maximizing
compensations offered by our benefits plan.
3. PEER REVIEW OF DISPUTE RESOLUTION:
Many plans provide a peer review mechanism through which disputes
between third parties, patients and dentists can be resolved, eliminating
many costly court cases. Peer review is established to ensure fairness,
individual case consideration and thorough examination of record,
treatment procedures and results. Most disputes can be resolved
satisfactorily for all parties.
4. PREMIUM ADJUSTMENTS AND REVALUATION:
Patients and plan purchasers should insist on regular reviews of premium
levels to ensure that UCR or Table of Allowances payment schedules are
equitable. This analysis can help optimize our benefit levels, ensuring
that every dollar is spending are used wisely.
5. CORDINATION OF BENEFITS:
If we are covered under two dental benefits plans, notify the administrator
or carrier of our primary plan about our dual coverage status. Plan
benefits coordination can help protect our rights and maximize our
entitled benefits. In some case we may be assured full coverage where

plan benefits overlap, and receive a benefit from one plan where the other
plan lists exclusion.
8. OPTIONS IN DENTAL INSURANCE
Everyone needs dental care. Unfortunately, not everyone knows there are
a variety of ways to pay for a dentist and dental care. There are more
choices than just traditional insurance and those choices can save our
money on our dental care. If we need a way to pay our dental care and
dental fees, here are 4 dental insurance options we may want to
consider:
1. TRADITIONAL DENTAL INSURANCE: These are the plans
mostly used to work similar to health insurance plans. With
traditional dental insurance plans we pay a weekly or monthly
premium and receive benefits such as 80 – 100 % of our dental
costs covered. We can find traditional dental insurance plans
through our employer or an insurance agent. Remember though, if
we go to an insurance agent and not to our employer than our cost
may be higher. Also, some procedures and prior problems may
have awaiting period or may not be covered. Always check with
our employer first when looking to purchase a dental plan.

2. DENTAL REIMBURESMENT PLAN: A dental reimbursement
plan is not insurance but instead a type of agreement between our
employer and us. With a dental reimbursement plan we pay for our
dental care then take our receipt to our employer and then
reimburse us up to a specified limit ( usually $ 500 - $ 1000 per
year). This is a great way for an employer to offer benefits to their
employees and neither party has to worry about paying monthly
premiums to an insurance company or has to worry about having
limited choices in a dentist. If we like the idea of having a dental
reimbursement plan in our work place just ask our employer.
3. VOLUNTARY GROUP PLANS: Want dental insurance at our
work place? Get together with our fellow co-workers and ask our
employer to set up a voluntary group dental insurance plan. With
this type of plan, our co-workers and we pay all the fees of the
dental insurance but it is set-up through our employer so we are
able to get a cheaper group rate and possibly better benefits. There
is strength in numbers.
4. DENTAL DISCOUNT PLANS: A dental discount plan can be a
great way to pay for our dentist and dental care at a lower cost.
Dental discount plans are not insurance but instead one would get a
specific discount on specific services. For Example: We go to the
dentist and the “off the street” fee is $ 100 for a visit and cleaning.
With a Dental discount plan, if its discount is 20 % then instead of
paying the normal $ 100 visit / cleaning fee we would only pay $
80 thus getting a 20 % discount on our services. These types of
plans usually require us to pay an enrollment fee and a monthly fee
to the dental discount plan provided but the fees are less than

insurance. Also, our dentist choices will be limited to the dentist in
our area that accepts the dental insurance plan.
5. WITH ANY DENTAL PLAN CHOICE: Look at all the facts
and find what will best fit our needs. For some, a dental discount
plan may be the best fit for them since the employer does not offer
any type of dental discount plan. And is not willing to negotiate a
plan in the work place. But for others, purchasing dental insurance
through their employer is best since they have a family to insure
and a history of dental problems. And in some instances, we may
feel just fine paying for a dental out of pocket and are not
interested in paying premiums all the time for dental insurance.
Most importantly, what ever we choose we will save more money
in the long run by keeping current with dental check ups to prevent
any expensive major damage in the future. We need a dentist but
don’t have dental insurance?
Everyone needs dental care. Unfortunately, not everyone knows there are
a variety of ways to pay a dentist and a dental care. There are more
choices than just traditional dental insurances and those choices can save
our money on our dental care.

9. EIGHT THINGS TO CONSIDER WHILE CHOOSING
DENTAL PLAN
What looks like a bargain today may not be a good buy in the long run?
While our out – of – pocket costs are, off course, an important part of our
decisions – making process when choosing a dental plan, they are not the
only criteria to use when evaluating our options. Our primary focus
should be to determine whether the coverage will satisfy our dental care
needs. Consider the following:
1. DOES THE PLAN GIVES US FREEDOM TO CHOOSE OUR
OWN DENTIST OR WE ARE RESTRICTED TO A PANEL OF
DENTISTS SELECTED BY INSURANCE COMPANIES?
If we have a family dentist with whom we are satisfied, consider the
effects changing dentists will have on the quality or quantity of care we
receive. Because regular visits to the dentists reduce the likelihood of
developing serious dental disease, it’s best to have and maintain an
established relationship with a dentist we trust.

2. WHO CONTROLS TREATMENT DECISIONS – WE AND OUR
DENTISTS OR THE DENTAL PLAN?
Many plans require dentists to follow treatment plans that rely on a Least
Expensive Alternative Treatment (LEAT) approach. If there are multiple
treatment options for a specific condition, the plan will pay for the less
expensive treatment option. If we choose a treatment option that may
better suit our individual needs and our long-term oral health, we will be
responsible for paying the difference in costs. It’s important to know who
makes the treatment decisions under our plan. These costs control
measures may have an impact on the quality of care we’ll receive.
3. DOES THE PLAN COVER DIAGNOSTIC, PREVENTIVE AND
EMERGENCY SERVICE? IF SO, TO WHAT EXTENT?
Most dental plans coverage for selected diagnostic services, preventive
care and emergency treatment that are basic for maintaining good oral
health. But the extent or frequency of the services covered by some plans
may be limited. Depending upon our individual oral health needs, we
may be required to pay the dentist directly for a portion of this basic care.
Find out how much treatment is allowed in any given year without cost to
us, and how much we will have to pay for our self.
Every dental care plan is different. It’s our responsibility to be informed
about what our specific plan will cover. As a basis of comparison, the
following services should be covered in full, with no deductible or patient
co-payment:
Initial Oral Examination – once per dentist
Recall Examinations – twice per year

Complete x – ray survey – once every three years
Cavity – detecting bite – wing X ray – once per year
Prophylaxis or teeth cleaning – twice per year
Topical Fluoride treatment – twice per year
Sealants – for those under age 18
4. WHAT ROUTINE TREATMENT IS COVERED BY THE
DENTAL PLAN? WHAT SHARE OF THE COST WILL BE
OURS?
While preventive care lessens the risk of serious dental disease, additional
treatment may be required to ensure optimal health. A broad range of
treatment can be defined as routine. Most plans cover 70 percent to 80
percent of such treatment. Patients are responsible for the remaining
costs. Examples of routine care include:
Restorative care – amalgam and composite resin filling and stainless steel
crowns on primary teeth
Endodontics – treatment of root canals and removal of tooth nerves
Oral Surgery – tooth removal (not including bony impaction) and minor
surgical procedures such as tissue biopsy and drainage of minor oral
infections.
Periodontics – treatment of uncomplicated periodontal disease including
scaling, root planning and management of acute infections or lesions.

Prosthodontics – repair and / or reseating of existing dentures and
bridges.
Understand what routine dental care by the plan, and what percentage of
the costs will come out of our pocket.
5. WHAT MAJOR DENTAL TREATMENT IS COVERED BY THE
PLAN? WHAT PERCENTAGE OF THESE COSTS WILL BE
REQUIRED TO BE PAID BY US?
Since dental benefits encourage us to get preventive care, which often
eliminates the need for major dental work, most plans are not generous
when it comes to paying for major dental work, most plans cover less
than 50 percent of the cost of major treatment. Most plans limit the
benefits -- both in number of procedures and dollar amount – that are
covered in a given year. Be aware these restrictions when choosing our
plan and as our dentist and we develop treatment best suited for us. Major
dental care includes:
Restorative care – gold restorations and individual crowns
Oral Surgery – removal of impact teeth and complex oral surgery
procedures
Periodontics – treatment of complicated periodontal disease requiring
surgery-involving bones, underlying tissues or bone grafts.
Orthodontics – treatment including retainers, braces and / or diagnostics
materials.
Dental Implants – either surgical placement or restoration

Prosthodontics – fixed bridges, partial dentures and removable or fixed
dentures.
6. WILL THE PLAN ALLOW REFFERAL TO SPECIALISTS?
WILL MY DENTIST AND I BE ABLE TO CHOOSE THE
SPECIALIST?
Some plans limits referrals to specialists. Our dentist may be required to
refer us to a limited selection of specialists who have contracted with the
plans third party. We also may be required to get permission from the
plan administrator before being referred to a specialist. If we choose a
plan with these limitations, make sure qualified specialists are available
in our area. Look for a plan with a broad selection of different of
specialist. If we have children we may prefer a plan that allows a
pediatric dentist to be our Childs primary care dentists. Since specialize
treatment is generally more costly than routine care, some plans
discourage the use of specialist. While many general practitioners are
qualified to perform some specialized services, complex procedures often
requires the skills of a dentist with special training. Discuss the option
with our dentist before deciding who is best qualified to deliver treatment.
7. CAN WE SEE THE DENTIST WHEN WE NEED TO? AND
SCHEDULE AN APPOINTMENT TIME CONVINIENT TO US?

Dentist participating in closed panel or capitation may have selected
hours to see plan patients. They may schedule appointments for these
patients on these given days, or at specific hours of the day, restricting
our access. Some dentist’s fee for seeing us on weekends or emergency
are high than those the plan allows. We may be required to pay the
additional costs our self. If we select these types of plans, have a clear
understanding of our dentist’s policies as well as the plans dentists – to –
patient ratio. It’s the best way to ensure our access to care is not unduly
restricted and that higher fees the plan does not cover do not surprise us.
8. WILL THE PLAN PROVIDE BENEFITS TO PATIENTS WHO
MAY ALSO BE COVERED BY OTHER DENTAL PLANS?
It is not unusual to be eligible for dual benefits. We may be covered
under our companies plan as well as under that of our spouse’s employer.
In analyzing our options, make sure to look for a plan that allows
coordination of benefits
We should be entitled to either 100 % coverage or some form of premium
credit. By coordinating benefits, we can eliminate being penalized or
denied coverage when the two plans have conflicting exclusions.
Choosing between dental insurance and discount dental plans can seem
confusing. However, when properly informed this decision can be easier
than we think. Finding which dental insurance plans or discount dental
plans are available, or right for us, can become a tedious task. TDIG has
brought together leading dental health organizations offering and discount
dental insurance. TDIG has taken the guess workout of choosing our
dental provider. We have compared these services to assist us in deciding
which best suits our needs.

10. SURVEY REPORT
Analysis of the Survey to find out the perception about Dental
Insurance in India
Q.1) Do you have Insurance?
This question helped us to find out the actual involvement of our sample
in insurance and as expected the result turned out to be quiet low, only
40% of the sample is insured. Still if we compare this percentage with
national figures it’s quite good.
Q.2) How much does it cost?

This question helped us to find out the amount people spend on Dental
Problems. And the results showed that 40% of the people spend till
Rs.1000 at Dental Clinic and majority of them spends till Rs.2000. This
shows that people spend a big amount for their Dental Care.
Q.3) Are you aware about Dental Insurance?
This question was asked to find out the awareness about Dental
insurance, which is a new concept in India. The result showed that around
60% of the people are aware about Dental Insurance.
Q.4) Do you think Dental Insurance can cover that cost?

As we got to know from previous questions that people spend a good
amount on Dental Care and they also are aware about Dental
Insurance which prompted us to ask them that do they think the
Dental Care fees can be covered through Dental Insurance. The
result showed that around 80% of the people are aware about the
benefits of Dental Insurance.
Q.5) Do you know that it has not yet introduced in India?
This question was asked to find out the awareness of the people about the
introduction of Dental insurance in India. The result showed that around

70% of the people were aware about unavailability of Dental Insurance in
the country
Q.6) Do you think it should be introduced in India?
This question was asked to find out the acceptance of Dental Insurance as
a concept in the country. The result showed that around 95% of the
people want Dental Insurance to be introduced in the country.
(i)
(ii) Conclusion on survey conducted

From the survey, it is observed that insurance in India is still at its
developing stage. Many of them are uninsured. Some are facing with
dental problems and are paying lump sum amount on it. Very few are
aware about of dental insurance. It concludes that dental insurance is not
flourishing well in India. It is a new concept in India. But introduction of
dental insurance would lead to growth in the Indian economy.
11. CASE STUDY
METLIFE-ABOUT CHOOSING A DENTIST
Selecting a dentist who meets our needs and expectations is a decision
that’s too important to make without investing our time and effort. When
we need a dentist, we want a professional we can trust. Don’t select a
dentist on the basis of cost or advertising alone.
Though daily brushing and flossing makes a difference, seeing a dentist
regularly is essential to keep our teeth, gums and mouth healthy. Through
regular visits and cleaning, our dentist can detect and remedy potential
problems, offering care that ensures a lifetime of good oral health. If we
don’t have a dentist, wait until a problem forces us to find one.
 WHERE TO START FROM?

Different types of dentists perform different types of services.
Determining which is right for us depends on our dental needs. Do we
need a routine cleaning? Do we require dentures? Could our child need
braces?
Dentists are grouped into two categories: general dentists and specialists.
Both general and specialty dentists are well qualified. They have received
a four-year doctorate degree in dentistry, which is referred to as either a
D.D.S. (doctor of dental surgery) or D.M.D. (doctor of dental medicines),
depending upon which college awards it. They also pass state and
national board examinations. Specialists, however, differ from general
dentists because they have undergone extra training in a particular area of
dentistry and limit their practice to that area.
(b) GENERAL DENTISTRY
General dentists, also known as family dentists, are trained to provide
most dental procedures for patients. A general dentist’s service may
include:
• Routine checkups
• X – rays
• Teeth cleanings
• Fillings
• Gum disease screening and treatment
• Extractions
• Crowns and bridges
• Cosmetic dentistry
• Root canal therapy
• Sealants
• Pediatrics dentistry

• Tobacco cessation
• Homecare instructions
• Dentures and partial dentures
• Mouth guards
After our dentist has determined our oral health status and our likely risk
of future disease, we should visit our dentist as often as he or she
recommends. Regular visits enable our dentist to become familiar with
our dental and medical history and to coordinate our dental care. This
practice can help prevent dental disease before it requires involved care,
such as a root canal or periodontal (gum) surgery.
If our general dentist determines us that we have a problem requiring
special skills, knowledge or equipment, he or she will refer to a specialist.
Our general dentist will explain to us why the referral is recommended,
and an appointment may be scheduled before we leave. He or she should
share our dental records, X-rays and any relevant dental and general
health information with specialty dentist.
(c) SPECIALTY DENTISTRY
A specialty dentist typically has completed two to six years of education
in a specific area of dentistry. After a dentist has successfully completed
additional programs and trainings, he or she may elect to take a specialty
examination.
Some specialists we may be referred to during the course of our dental
treatment include:
• Endodonist
Endodonists care for the inner portion of the teeth. They perform canals
and treat diseases of the pulp and nerves inside the tooth.

• Oral Pathologist Oral and Maxillofacial Surgeon
Oral and Maxillofacial surgeons treats injuries and defects of the mouth
and jaw; they also often perform complex tooth extractions. Oral
pathologists examine, identify, diagnose and treat diseases of the mouth.
• Orthodontist
Orthodontist design and apply corrective and supportive appliances
(braces) to realign crooked teeth.
• Pediatric dentists
Pediatrics dentists are for infants, children, adolescents and special
patients having psychological, physical or emotional problems. These
practitioners are skilled at handling the first visits to the dentist.
• Periodontist
Periodontists treat diseases of the soft tissues (gums) and bone that
surround and
support the teeth.
• Prosthodontist
Prosthodentists design, construct and fit replacement teeth, such as
implants,
bridgework and dentures.
 NARROWING CHOICE
If we don’t have a general or family dentist, now’s the time to select
one. If we have dental insurance, check to see if our dental plan
requires us to choose from a list of dentists who participate in the plan.
Some insurance plans allow us to choose an out-of-network dentist
(one who does not participate with the plan). Generally, our benefit
will be less.

Ask friends, relatives and coworkers for personal recommendations.
Inquire what dentists they see and whether they are satisfied with the
dentist’s service and quality of care. Ask our family physicians,
pharmacist and faculty members of a local dental school if they can
provide suggestions. Or contact the local or state dental society for
referrals. (They’re usually listed in telephone directories under
“dentists” or “associations.”) If we’re moving, our current dentist may
be able to make recommendation.
We also can check with a dental network or referral services. These
groups prescreen participants, generally recording dentists’
educational background, experience and specialty, as well as other
information, such as their ability to speak a second language. Be
aware, however, some services only list dentists who pay to be
included. To learn about a dentist’s credentials, we can check the
American Dental Directory at our local library.
Another consideration is the location of a dentist’s office. Ideally,
we’ll want it to be convenient to where we live or work. Find out, too,
about office hours. If needed, are evening or weekend appointments
available?
Once we’ve narrowed our list to two or three dentists call their offices
to ask preliminary questions, such as:
• Does the practice accept our dental plan?
• Is payment requested at the visit or will the dentist file our
insurance company claim and bill we for the balance?
• Is the dentist willing to set up a payment plan for more
comprehensive treatments? Are there various payment plans
offered?

• Does the dental staff use universal precautions for infection
control, such as gloves, masks, protective clothing and sterilized
instruments and work areas?
• What is the protocol for patients who have emergencies during
office hours, after office hours and when the dentist is away?
• Are patients notified when it’s time for a checkup? Are all patients
recalled every six months or is the recall level adjusted for
individual needs?
• Does the dentist treat children?
 PERSONAL EVALUATION
Because a trusting relationship between our dentist and us is so
important, we may wish to reserve time to ask question during the initial
examination.
• Will the dentist develop a treatment plan for us and discuss it with
us on a regular basis? Will the dentist provide treatment options?
• If needed, does the dentist utilize sedation, such as nitrous oxide?
• Does the dentist take and keep our medical and dental history on
file? How often does the dentist update our medical and dental
history?
• How are patients screened for periodontal disease?
• If we call the practice with a problem, will our call be put through
to the dentist? Are there established times for call to and from the
dentist? Are telephone calls returned the same day?
• Does the dentist take continuing education classes?
• Ask the dentist to explain anything we don’t understand. If we’re
dissatisfied with his or her answers, or uncomfortable with the

dentist’s manner, consider using another dentist from our list.
Remember, we should feel content with our decision.
While on our visit, make observations about the office.
• Is the office clean, neat and professional?
• Is the staff friendly, helpful and professional in manner and dress?
• Are patients seen promptly?
• Is the practice a high-volume operation in which the dentist rushes
from patient to patient? These dentists may be unwilling or unable
to spend extra time with us if we need it.
Once we’ve made our selection and scheduled a visit, be sure to inform
the practice about our dental benefit plan. If our dental benefit plan uses a
special claim form, bring one with the patient / employee portion
completed.

12. CONCLUSION
Dental insurance has a lot of importance in today’s world. It gives us an
idea to protect the mouth set and also encourages savings. Dental
insurance is well flourish all over the world. But it has not yet introduced
in India.
Everyone needs dental care .Taking care of teeth is not so affordable in
today’s modern world. Dental insurance provide different plans for
different needs. Dental insurance is equally important to a human being
as health insurance, as dental diseases is so common, being protected by
dental insurance and using it wisely are essential safeguards to any
individual or a family.
Insurance in India is still at its developing stage. Dental insurance is a
new concept all together. Dental insurance has a good scope in India in
near future. It should be encouraged to facilitate development by
providing dental services and savings to individual which in turn leads to
overall growth in the Indian economy.

13. BIBLIOGRAPHY
WEBSITES
www.dentalplans.com
www.dentalinsurance.com
www.individualdentalinsurance.com
www.metlife.com
www.dentaldiscountplan.com
www.123-dental-medical-insurance.com
www.dentalcare-indiatour.com
SEARCH ENGINES
www.yahoo.com
www.google.com

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