An In-depth Comparison Of Traditional Dental Insurance To DMPOs - Part 3
By Joseph Preziosi Jr., DMD
This is the third article in a series of three articles that compares traditional indemnity dental insurance (TIDI) to discount medical provider organizations (DMOP). This article will go into a detailed point-by-point comparison of policy limitations 9 through 18.
- With DMPOs there is never any downgrading of treatment procedures so the patient saves on the entire amount of the treatment. With TIDI the insurance company will often downgrade the treatment procedure to a less expensive one that they consider an acceptable alternative and therefore pay less benefits leaving the patient with a grater out of pocket expense than if the had paid benefits on the treatment that was actually performed.
- With DMPOs there is never any stalling on the patient’s saving because it is instant and there is no paper work to file. With TIDI they will often claim they never received the initial claim form and will ask for extraneous information from the patient and or the doctor.
- With DMPOs there is never any question on the amount the patient will save, it is always the discount rate times the entire treatment cost. With TIDI the patient can’t be sure of the benefit they will receive for any given procedure until after it is completed and submitted to the TIDI. Some procedures they wont cover at all and the percentage they claim they reimburse even on covered treatment procedures in on a dollar amount they indiscriminately determine and is very often less than what most doctors are charging.
- With DMPOs the patient saves on every treatment procedure every time without exception. With TIDI some treatment is claimed to be part of another unrelated treatment, so a patient may have two or three treatment procedures but will be reimbursed for only one. The TIDI claiming the other one or two treatment procedures are all covered under the one procedure they are paying benefits on.
- With DMPOs up to 10 family members are covered on the family plan without any additional premium charges. With TIDI sometimes only the employee will be covered by the policy the employer purchases thus leaving spouses and dependent children without coverage Some employers may allow the employees to purchase coverage for the rest of their family members at an additional cost to the employee.
- With DMPOs even dependant parents are covered as long as they reside at the same residence as the head of household policyholder and financial dependent on the policyholder. With TIDI dependent parents are not covered and can’t be added to the policy.
- With DMPOs a significant other, whether a same gender partner or heterosexual partner the policyholder is not married to, is covered as long as they reside at the same residence. With TIDI significant others are very very rarely if ever covered.
- With DMPOs dependent children are covered to the age of 26 without regard to their status as a full time student. With TIDI dependent children are covered to the age of 18 or 19 with out regard to their status as a student and to 23 or 24 only with documentation demonstrating they are full time students.
- With DMPOs there is never any difficulty in anyone purchasing a
policy. With TIDI if your employer doesn’t purchase the policy and
offer it as part of compensation benefits package it is nearly
impossible for an individual to find a TIDI company that is will to
write a policy for individuals regardless of the ability and
willingness to pay the premiums. With DMPOs there are far fewer policy restrictions in the fine print of the policy than with TIDI policies.
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/
