Even if you get dental insurance as part of a group, you get most of the same benefits as a plan for an individual, plus one more. You pay less for insurance because you are part of a group.
Dental insurance companies like to insure groups because the risk is spread out and because more people in the group means more business for them.
This is a benefit that many companies and unions offer to get and keep good employees. The effect is a very good one. This is so that the employee doesn't have to pay for as much of their dental plan out of their own pocket.
As a member of a group, your dental insurance plan is the result of a contract between your employer (or union), or plan sponsor, and a third party (insurance company). If you have questions about your plan's coverage, you should talk to the plan sponsor or your employer.
To get the most out of your dental plan, you should take the time to learn how it works and what it can't do. A good group dental plan pays for between 60 and 80% of each dental treatment you get.
Some things that all group dental insurance plans have in common
Direct Reimbursement programme
With this plan, the patient can go to any dentist they want. After treatment, the patient gets back some of the money they spent on dental care, no matter how big or small the procedure was.
The UCR programme stands for "Usual, Customary, and Reasonable."
This plan gives the patient options because they can go to their favourite dentist. The plan buyer and the third party payer work together to decide what a "reasonable" or "customary" fee limit is.
List or table of programmes that give money
Each service that is covered is listed and given a certain fee. The amount is how much the plan pays for the services. Most of the time, the patient has to pay the difference between what the plan pays and what the treatment costs.
Program for Preferred Provider Organization (PPO)
To get people to go to them, contracting dentists offer discounts on their service fees. Patients can't get these discounts, though, if they go to a dentist who isn't in this network.
Capitation programme
The dentist signs a contract with the plan's sponsor and performs all or a certain number of treatments that are covered by the plan. In exchange, each patient or subscriber pays the dentist a set fee.
