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Government Dental Plans - What Types of Government Dental Plans are Available?

Dental care coverage is of concern to government employees or those covered for their dental care by government-sponsored dental programs. Generally, government dental plans fall into two categories - traditional dental insurance plans and managed dental care plans.

Traditional Dental Insurance

Many people are familiar with traditional dental insurance . Since governments have such large programs, there is rarely any requirement to complete a health history form or waiting periods for dental care coverage. Premiums are paid monthly to the dental insurance carrier . Depending on the government entity, employees or covered individuals may be required to pay a percentage of their monthly premium for any dependents included on their selected plan.

Generally, traditional dental insurance requires that an annual deductible amount be fulfilled before reimbursing for dental care services provided by a dentist. Many dentists no longer accept direct or assigned payments from dental insurance companies, instead asking patients to complete reimbursement paperwork and negotiate directly with the insurance company for payment. Instead dentists ask that full payment for services be paid at the time of service or arrangements be made for payment.

The advantage of traditional dental insurance is that patients may see almost any dentist and do not usually need a referral to see the dentist. However, there are several disadvantages to traditional dental insurance. Besides many dentists not accepting direct payment from the insurance company, reimbursement rates for routine dental care may be surprisingly limited. Another disadvantage is that popular dentistry services such as cosmetic procedures like teeth whitening, veneers or dental implants are not included as covered benefits. Also, orthodontic services for adults are also rarely covered.

Managed Dental Care Plans

Just as managed health care plans have emerged in response to astronomically rising health care costs, managed dental care plans have also emerged as a factor in dental care . Similar to managed health care plans, members of managed dental care programs are given a list of network providers to use when selecting a dental care provider. Service rendered outside of the network may result in significantly lowered reimbursement rates or no reimbursement being allowed at all.

Managed dental care plans may or may not have an annual deductible amount and require monthly premiums. Depending on the government dental plan, the employee or covered individual may be required to pay for a portion of their monthly premium or the premium applied to dependents.

Dental care provided by a network dentist is limited to approved routine dental care services and a copay is required for each visit. Routine dental care services usually include cleaning provided by a dental hygienist, x-rays or fillings. Popular cosmetic dentistry services such as veneers, teeth whitening or dental implants to replace extracted teeth are often not included as covered services. Also, orthodontic services for adults are usually considered cosmetic in nature and not covered.

Summary

Government dental plans usually fall into two categories - traditional indemnity dental insurance plans and managed dental care plans . Each type of plan offers advantages including access to routine dental care and caps on annual out-of-pocket dental expenses. Disadvantages include limits on reimbursements for routine dental care services and no coverage for popular cosmetic dentistry procedures.