Direct Dental

Written by Jeremy Horelick
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Direct dental plans have become one of the most popular alternatives to traditional dental insurance coverage. Their lower fees and administrative simplicity make them obvious choices for both employers and employees. Companies save money by paying only for those benefits used, while workers retain the choice they've come to value when picking a dentist.

The first thing to understand about direct dental plans is that they are not insurance products, but rather self-funded (and self-directed) welfare programs. As such, they're exempt from many of the bureaucratic rules, regulations, and assessments that plague PPOs, HMOs, and other managed care solutions. With a self-funded direct dental program, patients pay out of pocket for treatment received, then file a reimbursement claim for a percentage of the full amount.

The Beauty of Direct Dental Plans

There are several distinguishing features of direct dental plans that make them so attractive for all the parties involved. Employers receive peace of mind in knowing that more of their benefits funds go directly toward patient care and not overhead costs and commissions. Patients, meanwhile, face no restrictions when selecting their doctors, which polls have shown to be the single most valuable factor in determining plan members' satisfaction.

Finally, the low incidence of fraud makes direct dental plans an economical choice for employers, employees, and reimbursement companies alike. Since patients pay directly for any and all benefits received, they're unlikely to authorize any sort of treatment that isn't immediately necessary. Moreover, since claim amounts typically range from 500 to 1,000 dollars, care providers have little if any incentive to cheat when it comes time for billing.


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