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Oral Health Care Cost

Insurance is expensive.  Whether it is car, home, health or dental insurance, it is going to cost the consumer to have coverage.  Generalinsurance can be confusing at times, but with a little research and time, you can find a plan which fits your needs.  Health insurance plans vary depending on what you want or need coverage for. Therefore, it is important that you know how your plan will be tailored to fit your needs, since this can be reflected in your coverage and deductibles.

Direct Reimbursement

This program pay you back an agreed upon percent of the amount you spent on a dentist visit, no matter what treatment you had done.  You usually can go to the dentist of your choice and encourages clients to work with their chosen dentist to improve their health in the long run.  By encouraging preventative measures, the company not only saves money in the future; but, cuts down on unnecessary treatments.

UCR Programs

UCR is the shortened version of usual, customary and reasonable programs.  This plan also allows patients to go to dentists of the choosing, and they also pay an agreed upon percentage of the fees charged, or what the administrator of the plan deems reasonable or customary, which ever one is the less amount of money.  These are usually contract plans.

What the administrator deems customary or reasonable may not be in line with what the healthcare provider charges however, and the out of pocket expense for the client maybe higher.  These plans are not regulated by law, so the definitions are not really accurate or clear.  Mainly it is up for interpretation.

Capitation Programs

The amount paid to dentists is a fixed amount with this plan.  That means that the dentist will accept the amount agreed upon, or that the client again, will have to pay whatever is left.

Predetermination of Costs

In this case, the insurance plan may ask that you or your dentist submit a treatment plan before treatment is delivered.  The plan governing body will then determine if the insured person is eligible for the treatment, services that will be paid for, etc.  Often known as precertification, this can take some time, and is usually done when there is extensive work that needs to be done.

It is up to the insurance company to decide if the patient will have to pay part of the fees, or in some cases all of the fees, if they do not agree with the plan of care or deem the services as not being required or necessary.  They can also refuse if the amount exceeds what is specified in the plan.

So, What Should You Look For?

Dental insurance should provide you coverage for the average problems that can come up like cavities and other issues.  They should also assist you in budgeting for dental care including the prevention of disease, cleaning and even major problems like cancer and other problems.

Look for a company that has a plan which is flexible and convenient for you, your budget and your health.  Preferably, routine tasks like cleanings, should be included in the treatment plan. 

Look at the deductible amount and decide if its really worth paying all those premiums for the amount of work that you are having done.  If it is routine cleaning, for instance, would paying insurance premiums for a year be more expensive than simply paying for the cleaning out of pocket?


As state at the beginning of this article, health insurance, dental insurance, car insurance or any kind of insurance can be confusing and frustrating.  There are a wide variety of plans available on the market today, but it can take time and patience to find the one that is perfect for you.

However, generalinsurance and dental insurance is something that people cannot live without sometimes.  Oral health is just as important as heart health.

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