Need help understanding Dental Insurance? Edison Dental Arts can help
This is the time of year when your employer will give you a choice of insurance plans for next year. You should know that according to NJ State law you must be offered a choice. For example, if your employer offers you a DMO, they must also offer alternative coverage, such as a PPO or Indemnity Plan. Be sure to select coverage which allows you to pick your dentist. Here is a brief description of the dental plans being offered by most employers.
1) Traditional Fee for Service or Indemnity Plan - This is the best type of plan available because it allows you to go to the dentist of your choice. This plan also allows a very competitive fee thus promoting quality dental care. While this may be the most expensive plan for your employer, it is the best plan for the patient. Examples are Delta Dental Premier and Horizon Traditional Plan.
2) PPO - This type of plan has an in network and out of network option. In network you are assigned a dentist who accepts a reduced fee. Out of network you choose your own dentist who receives reimbursement from the insurance company. In both scenarios the patient is responsible for the co-pay.
3) DMO- The most restrictive and least expensive. You are assigned a dentist who agrees to accept a very reduced fee, which many times compromises the quality of the dental care.
This office will submit to ALL insurance plans and will receive reimbursement from the Traditional plans and all PPO plans with an out of network benefit. If you have a PPO with an out-of-network option or a DMO you can still be treated in this office but you may receive a reduced benefit from the insurance company. However, the benefit you do receive is the comfort in knowing you are being provided quality health care. If you have any questions please call the office at any time. Dr. Vitale serves on the State Council for Dental Insurance Benefits and will be more than happy to discuss your plan with you.
We currently participate with Delta, Horizon, CIGNA and Guardian. In addition we will accept assignment from Met Life, Aetna, United Concordia, Principal and all major insurance carriers.
A Common Question We Receive:
If I am employed, retired or unemployed where can I buy dental insurance? Unfortunately in the State of New Jersey your options are very limited. DON'T get trapped into paying for a referral plan through a credit card company or an internet plan. What looks like a dental insurance, isn't. Always call us before paying for a plan. It's actually better to bank monthly premiums and pay the fee for service. This is "self insuring".
YEAR END PREPARATION
As we approach the end of the year be sure to schedule any needed dental care well in advance so that we can maximize your dental benefits for you. If you don't use your annual maximum, you lose it.