INDIVIDUAL - FAMILY
New York  DENTAL  INSURANCE
New York  DENTAL  PLANS


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Insurance
Company.com
is a specialist in New York dental insurance, New York dental plans, vision and prescription coverage programs for individuals, families and groups. 

We have been serving the dental community since 1983, you will find our licensed insurance agents are well informed and ready to assist you...

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Dental Insurance and Dental Plans types we offer:

Dental Insurance Disclosure

All of these dental plan types listed below may not be available in New York. If we are unable to offer a dental insurance plan, we will provide a dental discount plan, if available, and clearly state it. Please be sure to contact the plan dental office to confirm they are accepting new patients and they are accepting the dental plan you have selected. If you have any dental plan questions please feel free to contact our office during regular business hours. You will find our licensed insurance agents ready to assist you.

Our dental web site is very clear if you are selecting a dental insurance plan or a dental discount plan. We understand that there are many dental plan web sites popping-up all over the internet, claiming to offer "dental insurance" when in fact they do not and are not licensed to offer a dental insurance plan. If you find a site that says they offer dental insurance, they are "required" to show their insurance license information on the web site, as noted at the bottom of this page. If they don't, then report them to your local state department of insurance.

If you find a dental web site stating they offer "dental insurance" and in fact they don't, then take the opportunity to report that site to the search engine you found them on.

Our entire staff is licensed to offer, sell and service dental insurance. Always ask to speak with a licensed insurance agent. Ask them if they are licensed. Full disclosure is our 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:

    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.

 

Members in New York 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.

New York DENTAL, VISION AND PRESCRIPTION COVERAGE
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