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How is the Price Determined by the Insurance Company?

Sunday, Jan. 1st 2017 6:19 AM

The dental insurance programs (individual and family plans) are primarily based upon your residential zip code. Also, depending on the type of dental insurance plan other variables such as the maximum limitation, number of family members in the household, and age of the proposed insured are considered.

I found a website that only sells dental insurance (ShareofCost.com) in which you enter your state, zip code, and then determine the annual dental benefit limits for the policy you want to buy online. I also found several dental insurance plans at InsuranceCompany.com. This company has been around since 1983 and they are a licensed insurance agency in all 50 states.

Determining the dental premium varies quite a bit. Initially I spoke about your residential zip code. Inscomp.net offers a dental rating program for the consumer in which you enter your zip code and a bunch of dental plans are displayed from the cheapest to the most expensive premium. You need to be sure and pick out the dental insurance plans since it displays several different types and review them one by one.

In the insurance business, when an insurance plan is rated with various elements we call it an “underwritten program”. That is, the dental insurance plan premium is established by the underwriting insurance company through the calculation of the estimated loss of revenue due to you filing a claim (generally speaking).

Yes, dental insurance policies have claim forms which is the paper work the insurance company needs to pay you or the dentist for the services rendered. Most of the time, the dental office files the forms on your behalf, but you need to check with them to see if this is the case. Remember, the monthly rate is going to be higher with each member you put on the policy. Although this is not always true, in general, a single member will pay less premium than a family plan.

Also, in the metropolitan areas the premium rates are normally higher than those in the outlying or rural areas. In theory this is due to the higher costs of services that are then passed down to the consumer. Dental insurance is a great option but you need to be aware of the underwriting guidelines before you buy. This is much the same as buying auto insurance, so consider shopping around or find a dental rating service as noted to help you locate the plans for you.

Please keep in mind there are many websites and companies who claim to sell dental insurance when in fact they do not. I have been a licensed insurance agent and broker for over 25 years and the bait-and-switch approach of unsuspecting consumers rages on from dental insurance to dental discount plans.

I have placed a disclaimer at the bottom of this article which may interest you…

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DISCLAIMER: Please be sure to contact the dental office to confirm they are accepting new patients and they are accepting the dental insurance plan you are considering.

Finding the right value in individual and family dental insurance is an important step in purchasing affordable dental insurance health care coverage. Both types of dental plans (dental insurance and discount dental plans) have advantages and disadvantages and one size does not fit everyone. Keeping this in mind is an important guideline when you shop for the dental plan that best fits your needs.

I 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 and sell 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. If they do not, 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 do not, then take the opportunity to report that site to the search engine you found them on.

Always ask to speak with a licensed insurance agent.

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