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IF YOUR FIRM PUTS THE BITE ON YOU WITH A DENTAL HMO, CHECK IT OUT
(MONEY Magazine) – If you work for a company with 100 or more employees, chances are your dental bills don't have much teeth. That's because nearly 90% of such companies provide dental plans that pick up 50% to 100% of your cost and let you choose any dentist you please. But that comfortable scenario is likely to change under health-care reform. If President Clinton's broad package of benefits is enacted, warns Bob Eicher of the Foster Higgins consulting firm in New York City, many companies will pay more for health coverage. "They'll need to save somewhere, and dental care -- which Clinton's plan provides for children but not for adults, except in some emergencies -- is a likely spot." One probable result: More companies will drop their conventional dental insurance in favor of managed dental-care plans -- essentially, dental health maintenance organizations. Here's what you should know: Dental HMOs limit you to seeing dentists enrolled in the plan but charge premiums that can cost as much as 30% less than those of an unrestricted plan. Typically, your deductible is zero, compared with $25 to $50 a year under a conventional plan, and the dental HMO pays 100% of the cost of preventive and routine services instead of 50% to 80% (both types of plans provide roughly equal maximum annual payments of $1,000 or so for orthodontics). If your company offers a choice between a traditional plan and a dental HMO, as some 10% of employers now do, should you try managed care? You should, says Donald Mayes, a Hershey, Pa. expert on dental benefits, provided that the answer is yes to these four questions: -- Does the plan hold administrative expenses to no more than 15% of its budget, leaving enough for patient care? -- Are preventive services such as exams, routine fillings and cleanings covered at no out-of-pocket cost? -- Is the wait for nonemergency care four weeks or less? -- Do its general dentists belong to the American Academy of General , Dentistry, and are specialists board eligible or board certified by appropriate dental groups? BOX: There should be no extra charge for routine care. |
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