Monthly Archives: October 2011

Types of policy

Here are the types of dental policies offered in Florida:

Florida Dental Discount Plan

The way Florida Dental Discount Plan works is that you get a discount for the prices of the services that you may need to get your teeth fixed.  These prices are negotiated with all the dentists that belong in your network of providers.  You go to the dentist and get your work done.  They charge you the rates the agreed to.  Typically, you get about 20 to 30% discount for the services rendered.

Dental HMO

A Dental HMO (Health Maintenance Organization) plan requires that you pay a co-payment when you finish the dentists in these plan.  The dentist are paid a month rate based on the number of patients in their area and are likely to visit them.

PPO Dental Plan

A PPO (Preferred Provider Organization) Dental Plan is one in which a particular group of patients are designed to received service from a group of dentists.  The participating dentists agree to charge less to those patients in the plan.  The key is you must see those dentist in the plan otherwise you have to pay more.

Florida office of Insurance Regulation

The Florida office of Insurance Regulation is the office assigned to the task of regulating insurance companies in all sectors in the State of Florida.  The office services Floridians through its responsibilities for regulation, compliance and enforcement of statutes related to the business of insurance.

The Office has several branches.  The Accident & Health Insurance branch is the branch assigned to regulating Dental Insurance Plans.  Accident & Health insurance can varies significantly by coverage. Basic Medical Coverage usually includes coverage for hospital stays (a portion of room and board), and surgical and medical costs associated with treatment. Basic coverage usually pays a fixed amount to providers based on a “usual, reasonable and customary” standard. In addition to the basic benefits, Major Medical Coverage may pay for a portion of blood transfusions, prescription drugs, and out-of-hospital costs, including doctor’s visits.  With Dental Insurance policy the coverage is not as extensive as regular health insurance policies.

Accident & Health insurance can also vary by delivery method. Traditional Health (or indemnity coverage) typically allows the insured to select any doctor or hospital and reimburses a portion of these costs. Managed Care plans usually involve a network of doctors and hospitals, and provide financial incentives to utilize the network; each plan has different reimbursement and costs schedules for “out of network” providers. Some managed care arrangements include: Health Maintenance Organizations (HMOs), Exclusive Provider Organizations (EPOs), Preferred Provider Organizations ( aka PPOs), and Point-of-Service Plans.

In the later portions of this website we will work you through all the types of dental insurance policies and how they affect you.