An In-depth Comparison Of Traditional Dental Insurance To DMPOs - Part 1
By Joseph Preziosi Jr., DMD
This is the first of a series of three articles that explores the changing landscape of dental insurance in our new age. This article is an overview comparison of traditional indemnity dental insurance (TIDI) policies and discount medical provider organization (DMPO) policies. The second article in this series will compare the points elucidated in this article in more detail offering an in-depth point-by-point comparison of the two programs.
As we enter a new millennium, traditional indemnity dental insurance becomes more and more obsolete because its annual maximum benefit remains stuck in the mid to late 1960's while its treatment fee allowances continually lag 5 to 10 years behind the times.
The lack of benefits has rendered traditional indemnity dental insurance little more than two inexpensive continuing care visits, consisting of an examination, prophylaxis (cleaning) and radiographs (X-rays) per year and help with minor restorative treatment, such as a few direct restorations (fillings). Couple these facts with all the other policy restrictions that are elucidated below and it is easy to see why patients and employers are seeking alternatives to traditional indemnity dental insurance.
Fortunately today discount medical provider organizations, or DMPOs, offer policies that overcome most of the policy limitations of traditional indemnity dental insurance.
The table below is a quick reference for comparison between the traditional indemnity dental insurance policy and the discount medical provider organization policies.
18 Reasons Why Coverage With DMOP Is Better Than Traditional Indemnity Dental Insurance
| Coverage Limitations |
DMPO | TIDI |
| 1. Limited Benefits |
No | Yes |
| 2. Deductible | No | Yes |
| 3. Treatment Exclusions | No | Yes |
| 4. Frequency Limits | No | Yes (months to years) |
| 5. Pre-existing Condition Exclusions | No | Yes |
| 6. Elective and Cosmetic Exclusions | No | Yes |
| 7. Delayed Reimbursement | No | Yes (weeks to months) |
| 8. Extra Documentation | No | Yes |
| 9. Downgrading Of Treatment | No | Yes |
| 10. Stall Tactics On Benefits | No | Yes |
| 11. Unknown Benefit Levels |
No | Yes |
| 12. Bundling |
No | Yes |
| 13. Restriction On Covered Family | No | Yes |
| 14. Restrictions On Dependant Parents | No | Yes |
| 15. Restrictions On Significant Others | No | Yes |
| 16. Proof Of Fulltime Student Status | No | Yes |
| 17. Difficult To Purchase | No | Yes |
| 18. A Multitude Of Policy Minutia | No | Yes |
What should be evident from this overview article is that there are far fewer restrictions on discount medical provider organization policies then there are with traditional indemnity dental insurance policies. Considering the limited annual dollar amount offered in benefits with the traditional indemnity dental insurance policies combined with the fact that elective and cosmetic treatment procedures are not covered at all, and are the treatment procedures most sought after by patients today, it is easy to see why many people are turning to the discount medical provider organization as an alternative or even a supplement to the traditional indemnity dental insurance policy.
Patients today are demanding more and more high quality aesthetically pleasing cutting edge dental treatment than ever before and this is only going to increase in the future. Patients also want to be able to rehabilitate their mouths and employ the state of the art dental treatment, such as implants, sinus lifts and bone grafts, to achieve the aesthetic and functional results they want. These large treatment cases can only be supplemented to a significant degree by policies that have unlimited benefits and few or no treatment exclusions. Traditional indemnity dental insurance fails miserably in both of these criteria.
About the Author:
Joseph Preziosi Jr., DMD
New Jersey Cosmetic Dentist
phone. (908) 654-7100
fax 908-654-8764
email: Drpreziosi@aol.com
url: http://www.preziosidentistry.com/