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Abbeville
Aberdeen
Adams Run
Aiken
Alcolu
Allendale
Anderson
Andrews
Arcadia
Awendaw
Aynor
Ballentine
Bamberg
Barnwell
Batesburg
Bath
Beaufort
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Belton
Belvedere
Bennettsville
Berea
Bethera
Bethune
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Blacksburg
Blackstock
Blackville
Blair
Blenheim
Bluffton
Blythewood
Boiling Springs
Bonneau
Bowling Green
Bowman
Bradley
Branchville
Brookdale
Brunson
Buffalo
Burton
Cades
Calhoun Falls
Camden
Cameron
Campobello
Canadys
Carlisle
Cassatt
Catawba
Cayce
Centenary
Centerville
Central
Chapin
Chappells
Charleston
Cheraw
Cherryvale
Chesnee
Chester
Chesterfield
Clarks Hill
Clearwater
Clemson
Cleveland
Clifton
Clinton
Clio
Clover
Columbia
Conestee
Converse
Conway
Coosawatchie
Cope
Cordesville
Cordova
Cottageville
Coward
Cowpens
Crocketville
Cross
Cross Anchor
Cross Hill
Dale
Dalzell
Darlington
Daufuskie Island
Davis Station
Denmark
Dentsville
Dillon
Donalds
Dorchester
Drayton
Due West
Duncan
Early Branch
Easley
Eastover
Edgefield
Edgemoor
 
Edisto Island Effingham
Ehrhardt
Elgin
Elko
Elliott
Elloree
Enoree
Estill
Eutawville
Fair Play
Fairfax
Fairforest
Fingerville
Florence
Floyd Dale
Folly Beach
Forest Acres
Forestbrook
Fork
Fort Lawn
Fort Mill
Fountain Inn
Furman
Gable
Gadsden
Gaffney
Galivants Ferry
Gantt
Garden City
Garden City Beach
Garnett
Gaston
Georgetown
Gifford
Gilbert
Glendale
Gloverville
Golden Grove
Goose Creek
Gramling
Graniteville
Gray Court
Great Falls
Greeleyville
Green Pond
Green Sea
Greenville
Greenwood
Greer
Gresham
Grover
Hamer
Hampton
Hanahan
Hardeeville
Harleyville
Hartsville
Heath Springs
Hemingway
Hickory Grove
Hickory Tavern
Hilda
Hilton Head Island
Hodges
Holly Hill
Hollywood
Honea Path
Hopkins
Horatio
Huger
Inman
Irmo
Islandton
Isle of Palms
Iva
Jackson
Jacksonboro
Jamestown
Jefferson
Jenkinsville
Joanna
Johns Island
Johnsonville
Johnston
Jonesville
Judson
Kershaw
Kinards
Kingstree
La France
Ladson
Lake City
Lake View
Lake Wylie
Lamar
Lancaster
Lando
Landrum
Lane
Langley
Latta
Laurel Bay
Laurens
Leesville
 
Lexington Liberty
Liberty Hill
Little Mountain
Little River
Little Rock
Little Switzerland
Lobeco
Lockhart
Lodge
Long Creek
Longs
Loris
Lowndesville
Lugoff
Lumberton
Luray
Lydia
Lyman
Lynchburg
Manning
Marietta
Marion
Martin
Mauldin
Mayesville
Mayo
Mc Bee
Mc Clellanville
Mc Coll
Mc Connells
McCormick
Miley
Minturn
Modoc
Moncks Corner
Monetta
Monticello
Montmorenci
Moore
Mount Carmel
Mount Croghan
Mountain Rest
Mountville
Mt Pleasant
Mullins
Murrells Inlet
Myrtle Beach
Neeses
Nesmith
New Ellenton
New Zion
Newberry
Newry
Nichols
Ninety Six
Norris
North
North Augusta
North Charleston
North Myrtle Beach
Northlake
Norway
Oak Grove
Olanta
Olar
Orangeburg
Pacolet
Pacolet Mills
Pageland
Pamplico
Parker
Parksville
Parris Island
Patrick
Pauline
Pawleys Island
Peak
Pelion
Pelzer
Pendleton
Perry
Pickens
Piedmont
Pineland
Pineridge
Pineville
Pinewood
Pinopolis
Plum Branch
Pomaria
Port Royal
Prosperity
Rains
Ravenel
Red Bank
Red Hill
Reevesville
Reidville
Rembert
Richburg
Richland
Ridge Spring
Ridgeland
Ridgeville
 
Ridgeway Rion
Rock Hill
Roebuck
Round O
Rowesville
Ruby
Ruffin
Russellville
Saint Helena Island
Saint Matthews
Saint Stephen
Salem
Salley
Salters
Saluda
Sandy Springs
Santee
Sardinia
Saxon
Scotia
Scranton
Seabrook
Sellers
Seneca
Seven Oaks
Sharon
Shaw
Shaw A F B
Sheldon
Shell Point
Silverstreet
Simpsonville
Six Mile
Slater
Smoaks
Smyrna
Socastee
Society Hill
South Congaree
Spartanburg
Springdale
Springfield
St Andrews
St George
Starr
Startex
State Park
Stateburg
Sullivans Island
Summerton
Summerville
Sumter
Sunset
Surfside Beach
Swansea
Sycamore
Tamassee
Tatum
Taylors
Tega Cay
Tigerville
Tillman
Timmonsville
Townville
Travelers Rest
Trenton
Troy
Turbeville
Ulmer
Una
Union
Valley Falls
Van Wyck
Vance
Varnville
Vaucluse
Wadmalaw Island
Wagener
Walhalla
Wallace
Walterboro
Ward
Ware Shoals
Warrenville
Waterloo
Wedgefield
Welcome
Wellford
West Columbia
West Union
Westminster
Westville
White Oak
White Rock
White Stone
Whitmire
Williams
Williamston
Williston
Windsor
Winnsboro
Woodruff
Yemassee
York
 

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Traditional dental insurance is often perceived as the best way to pay for dental expenses. And while dental insurance is an excellent option when sponsored by your employer, it may not be very cost effective when you are paying for it.

Most individual dental insurance plans require you to satisfy waiting periods and deductibles before having major and sometimes even minor restorative work done. Discount dental plans help make maintaining good oral health a lot more affordable. And, with no waiting periods or complicated coverage procedures, dental discount plans are about as simple as you can get.

How do discount dental plans work? As we become aware about our oral health, there has been a demand for affordable dental care. Discount dental plans are the newest option for those without coverage. These dental discount plans are much cheaper than traditional dental insurance, and also offer almost equal coverage for all dental work, even cosmetic procedures not covered by standard indemnity dental plans.

The catch is that dental discount plans are not really insurance at all. They work more like club memberships, where the cost of membership (your "premium") earns a steep discount on any club service (dental work) you buy. The discount normally applies to all dental office services performed by an approved "plan" dentist, but no procedure is covered completely.

What are the ins and outs of discount dental plans? When it comes to dental discount plans, the good news is afford ability, breadth of services, and immediate coverage. The bad news is greater financial risk and responsibility on your part.

Although the monthly cost of most discount dental plans is very low compared to the price of a traditional dental insurance or indemnity insurance policy, there's more allover financial risk with a dental discount plan. No care is totally covered, so an expensive procedure will mean a big out-of-pocket expense, even with the dental plan. And even when undergoing a low-cost service (like cleaning), you'll still be expected to pick up a part of the cost.

However, on the plus side, discount dental plans are effective immediately - so are many procedures you need now will be covered as soon as you buy the dental discount plan. Traditional indemnity and/or insurance dental plans usually impose a waiting period of between 6 and 18 months for any major procedure. The last "pro" is that all good dental discount plans should come with a money-back guarantee.

Indemnity Plans

This type of dental plan pays the dental office (dentist) on a traditional fee-for-service basis. A monthly premium is paid by the client and/or the employer to an insurance company, which then reimburses the dental office (dentist) for the services rendered. An insurance company usually pays between 50% - 80% of the dental office (dentist) fees for a covered procedures; the remaining 20% - 50% is paid by the client.

These plans often have a pre-determined or set deductible amount which varies from plan to plan. Indemnity plans also can limit the amount of services covered within a given year and pay the dentist based on a variety of fee schedules. Some typical features of these plans:

  • High deductibles before coverage begins (well-designed plans don't apply the deductible to preventive services)

  • Probationary periods on certain procedures that last up to a year

  • Annual dollar limit on benefits

  • Chose your own dentist

  • Your average monthly cost: $15 to $25

  • Companies selling these plans are regulated by state insurance departments.

Dental HMOs

These insurance plans, also known as "capitation plans," operate like their medical HMO cousins. This type of dental plan provides a comprehensive dental care to enrolled patients through designated provider office (dentist). A Dental Health Maintenance Organization (DHMO) is a common example of a capitation plan. The dentist is paid on a per capita (per person) basis rather than for actual treatment provided.

Participating dentists receive a fixes monthly fee based on the number of patients assigned to the office. In addition to premiums, client co-payments may be required for each visit. Some typical features of these plans:

  • Monthly premiums (some require you to prepay a year's worth)

  • Co-payments for office visits

  • Free preventive or routine care

  • You must select from an approved network of dentists

  • May have an initial enrollment fee

  • Annual dollar cap

  • Your average monthly cost: $5 to $15

  • Companies selling these plans are regulated by state insurance departments.

Preferred Provider Organizations

Another true insurance plan, a Preferred provider organizations ( PPO) falls somewhere between an indemnity plan and a dental HMO. This plan allows a particular group of patients to receive dental care from a defined panel of dentists. The participating dentist agrees to charge less than usual fees to this specific patient base, providing savings for the plan purchaser.

If the patient chooses to see a dentist who is not designated as a "preferred provider," that patient may be required to pay a greater share of the fee-for-service.  A group of dentists agrees to provide services at a deeply discounted rate, giving you substantial savings — as long as you stay in their network. Unlike the more restrictive DHMO, though, you can go out of network and still receive some benefits. Some typical features of these plans:

  • Monthly premiums

  • Annual dollar cap

  • You must stay within the approved network of dentists or pay higher deductibles and co-payments

  • Your average monthly cost: $20-25

  • Companies selling these plans are regulated by state insurance departments.

Dental Discount

This type of dental plan is not insurance. The managing organizations have negotiated with local dental offices to establish a set price for a particular dental procedure and offer deep discounts (some up to 70%) off the regular ADA pricing code.

This plan has several advantages over traditional dental insurance plans, namely, there are no exclusions for pre-existing conditions. This allows a patient to receive immediate coverage for work without meeting any waiting period requirements.

Direct Reimbursement Plans

A dental care plan now coming into vogue is the direct reimbursement plan. This is a self-funded benefit plan — not insurance — in which an employer pays for dental care with its own funds, rather than paying premiums to an insurance company or third-party administrator.

You, the patient, pay the full amount directly to the dentist, then get a receipt detailing services rendered and the cost, which you show to your employer. The employer reimburses you for part or all of the dental costs, depending on your specific benefits.

Your company might reimburse 100 percent of your first $100 of dental expenses and then 80 percent of the next $500, and 50 percent of the next $2,000, with a total annual maximum benefit of $1,500. Or it might reimburse only 50 percent of your first $1,000, resulting in a $500 yearly cap.

Some typical features of a direct reimbursement plan:

  • Neither you nor your employer pay monthly premiums

  • Freedom to choose any dentist

  • Typical employer cost: depends on the number of employees and benefit caps

  • Benefits usually capped at $500 to $2,000 annually.

Dental care is quite different than medical care. Major illness can strike at any time and the costs can be enormous. Most dental disease is preventable and treatment is predictable. Regular checkups and professional cleaning can help maintain your oral health and so dental benefits are written to encourage patients to seek preventative care in order to prevent more serious dental problems.

What do you look for in choosing a plan?

Does the plan give you the freedom to choose your own dentist or are you restricted to a panel of dentists selected by the insurance company? If you have a family dentist with whom you are satisfied, consider the effects changing dentists will have on the quality or quantity of care you receive. Because regular visits to the dentist reduce the likelihood of developing serious dental disease, it's best to have and maintain an established relationship with a dentist you trust

Who controls treatment decisions--you and your dentist or the dental plan? Many plans require dentists to follow treatment plans that rely on a Least Expensive Alternative Treatment (LEAT) approach. If there are multiple treatment options for a specific condition, the plan will pay for the less expensive treatment option.

If you choose a treatment option that may better suit your individual needs and your long-term oral health, you will be responsible for paying the difference in costs. It's important to know who makes the treatment decisions under your plan. These cost control measures may have an impact on the quality of care you'll receive.

Does the plan cover diagnostic, preventive and emergency services? If so, to what extent? Most dental plans provide coverage for selected diagnostic services, preventive care and emergency treatment that are basic for maintaining good oral health.

But the extent or frequency of the services covered by some plans may be limited. Depending upon your individual oral health needs, you may be required to pay the dentist directly for a portion of this basic care. Find out how much treatment is allowed in any given year without cost to you, and how much you will have to pay for yourself.

  • Initial Oral Examination----once per dentist

  • Recall Examinations----twice per year

  • Complete x-ray survey----once every three years

  • Cavity-detecting bite-wing x-rays----once per year

  • Prophylaxis or teeth cleaning----twice per year

  • Topical Fluoride treatment----twice per year

  • Sealants----for those under age 18

What routine corrective treatment is covered by the dental plan? What share of the costs will be yours? While preventive care lessens the risk of serious dental disease, additional treatment may be required to ensure optimal health. A broad range of treatment can be defined as routine. Most plans cover 70 percent to 80 percent of such treatment. Patients are responsible for the remaining costs. Examples of routine care include:

  • Restorative care - amalgam and composite resin fillings and stainless steel crowns on primary teeth

  • Endodontics - treatment of root canals and removal of tooth nerves

  • Oral Surgery - tooth removal (not including bony impaction) and minor surgical procedures such as tissue biopsy and drainage of minor oral infections.

  • Periodontics - treatment of uncomplicated periodontal disease including scaling, root planning and management of acute infections or lesions

  • Prosthodontics--repair and/or relining or reseating of existing dentures and bridges.

What major dental care is covered by the plan? What percentage of these costs will you be required to pay? Since dental benefits encourage you to get preventive care, which often eliminates the need for major dental work, most plans are not generous when it comes to paying for major dental work, most plans cover less than 50 percent of the cost of major treatment.

Most plans limit the benefits--both in number of procedures and dollar amount--that are covered in a given year. Be aware of these restrictions when choosing your plan and as you and your dentist develop treatment best suited for you. Major dental care includes:

  • Restorative care--gold restorations and individual crowns

  • Oral Surgery--removal of impacted teeth and complex oral surgery procedures.

  • Periodontics--treatment of complicated periodontal disease requiring surgery involving bones, underlying tissues or bone grafts.

  • Orthodontics--treatment including retainers, braces and/or diagnostic materials.

  • Dental Implants--either surgical placement or restoration

  • Prosthodontics--fixed bridges, partial dentures and removable or fixed dentures.

Will the plan allow referrals to specialists? Will my dentist and I be able to choose the specialist? Some plans limit referrals to specialists. Your dentist may be required to refer you to a limited selection of specialists who have contracted with the plan's third party. You also may be required to get permission from the plan administrator before being referred to a specialist. If you choose a plan with these limitations, make sure qualified specialists are available in your area. Look for a plan with a broad selection of different types of specialists.

If you have children, you may prefer a plan that allows a pediatric dentist to be your child's primary care dentist. Since specialized treatment is generally more costly than routine care, some plans discourage the use of specialists. While many general practitioners are qualified to perform some specialized services, complex procedures often require the skills of a dentist with special training. Discuss the options with your dentist before deciding who is best qualified to deliver treatment.

Can you see the dentist when you need to, and schedule appointment times convenient for you? Dentists participating in closed panel or capitation plans may have select hours to see plan patients. They may schedule appointments for these patients on given days, or at specified hours of the day, restricting your access.

Some dentist's fees for seeing you on weekends or during emergencies are high than those the plan allows. You may be required to pay additional costs yourself. If you select these types of plans, have a clear understanding of your dentist's policies as well as the plan's dentist-to-patient ratio. It's the best way to ensure your access to care is not unduly restricted and that you are not surprised by higher fees the plan does not cover.

Insurance companies do their best to ensure that their policyholders understand their plans and benefits, but it is up to an individual to make sure that they are making informed choices. The differences in the various plans you can choose from are:

  • The type of third party funding the plan.

  • Methods of selecting a dentist.

  • Compensation of the dentist's services to you.

  • The calculations of benefits and payments.

Understanding these differences will enable you to make an informed decision when selecting a dental plan that is best for you or your family.

Members can save on all dental charges and procedures including dental restorative cosmetic work (fillings, dental crowns, dental braces, dental implant's) and dental product related items, etc.), dental hygiene services, preventative work (teeth cleaning, x-rays, etc).  General dentistry, dental hygienist, dental assistant, dental assisting and all specialties where available are covered.

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