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Dental Insurance

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Dental Insurance In the past 30 years, dental insurance has grown from a rare fringe benefit to standard fare in many employee health-care packages.

About 156 million Americans have dental coverage, estimates Evelyn Ireland, executive director of the National Association of Dental Plans, a Dallas-based trade organization whose members include providers of managed-care and other dental plans.

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Of that total, roughly 90 million have traditional indemnity plans; 60 million have managed-care plans; and 6 million operate on a referral system, going to dentists who have agreed to offer special rates, Ireland says. Referral systems, however, are not insurance plans.

People who work for large companies are most likely to have dental coverage. About 90 percent of employers with 500 or more employees offer dental benefits. Across the board, about 50 percent of companies offer dental coverage, Ireland says. The self-employed are the least likely to be covered.

Despite the growth of dental plans, many companies do not consider dental benefits as crucial as medical coverage. When companies look at what to offer employees, "Dental plans are at the bottom of the pile," says Ray Werntz, president of the Consumer Health Education Council, a Washington, D.C. organization formed by the Employee Benefits Research Institute (EBRI). Since individual dental plans are not particularly profitable for providers, few are offered.

Human-resource experts say that dental plans are more predictable in terms of expenses than medical plans. The average dental claim, according to Ireland, is just $150. Medical plans, not surprisingly, are still viewed as more crucial for employees. When a budget crunch hits a company, employers often decrease dental-plan benefits before they touch medical benefits.

How to Decipher the Plans


If you're faced with making a decision about a dental plan, it pays to educate yourself first. Start by finding out which type of plan your employer is offering, suggests James Marshall, director of the Council on Dental Benefit Programs for the American Dental Association.

Fee-for-service plans include direct-reimbursement plans, which are plans funded by individual companies. They typically reimburse employees according to money spent, not treatment type. Patients can choose any dentist.
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