Freedom of Choice in Dental Insurance Plans

It is hard to disagree with the fact that freedom of choice in dental insurance plans has led to a substantial increase in the cost of dental services. Therefore, a large number of Americans report “cost as a barrier to dental care” (Thomas, Nasseh, & Vujicic, 2013, p. 2), which results in their dental needs being unmet. Waiting periods is another factor that drives up the cost of dental care in the country. A waiting period is a delay between the time of purchase of an insurance and the onset of coverage. Such delays are necessary to ensure that people with pre-existing conditions do not enroll in a program just to drop a plan after a major procedure is performed.

Given that GEHA Connection Dental Federal plan does not have waiting periods, which restrict policy holders from receiving procedures that do not fall into the category of preventative care, it is a great choice that demonstrates a depth of understanding of the issue. Undoubtedly, the plan’s premiums are higher because of the lack of waiting periods. While a high GEHA plan costs $38.03, the premiums for a standard GEHA plan are 41.9 percent lower—$22.08 (OPM, 2017). Taking into consideration that there is no substantial difference between the coverage of these plans, it can be argued that the variation in actuarial value is partially dictated by waiting periods.

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According to Nasseh and Vujicic (2017), average premiums for dental plans that fall into the category of high actuary levels was $33.43 in 2016. Despite the fact that the plan’s premiums are higher than average for high-actuarial-value dental insurance plans, the lack of waiting time for immediate needs makes GEHA plan an optimal choice for a young person.

The number of providers is an exceptionally important factor in the face of ever-increasing expenditures on dental care. However, the quality of providers is essential when it comes to both curbing costs of services and reducing the incidence of oral diseases through effective delivery of skilled and thoughtful care.

It can be quite difficult to compare quality measures of different plans because there are many factors that have to be considered during the process of narrowing down provider choices. It can be argued that the decision to opt for the Delta Dental PPO standard plan is reasonable from a financial point of view. According to Claxton et al. (2013), the analysis of dental plan enrolment distribution shows that preferred provider organization (PPO) plans were the most common plans for businesses in 2013.

The key advantage of Delta Dental PPO is its flexibility, which allows insured individuals to select dentists and dental specialists. Zip code search shows that there are almost 500 dentists who are willing to take the plan (Providers4you, n.d.). However, even though Delta Dental PPO is not less affordable than other dental insurance plans, it covers only a portion of dental care costs: 45 percent for basic restorative services and 65 percent for major restorative services (Delta Dental, 2015). Despite this limitation, the plan is likely to offer better services than other plans. Also, it has fewer limitations than health maintenance organizations (HMO) plans (Claxton et al., 2013). Many individuals and families recognize numerous advantages of PPO plans. According to a recently published research brief issued by American Dental Association (ADA), PPOs are “by far the most common type of plan offered by employers” (Yarbrough, Vujicic, Aravamudhan, & Blatz, 2016, p. 3).

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References

Claxton, G., Rae, M., Panchal, N., Damico, A., Whitmore, H., Bostick., & Kenward, K. (2013). Health benefits in 2013: Moderate premium increases in employer sponsored plans. Health Affairs, 32(9), 1667-1676.

Delta Dental. (2015). Delta Dental’s federal employees dental program. Web.

Nasseh, K., & Vujicic, M. (2017). Dental plan premiums in the Affordable Care Act marketplaces trended downward from 2014 through 2016. The Journal of the American Dental Association, 148(4), 230-235.

OPM. (2017). Dental & vision: Plan information. Web.

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Providers4you. (n.d.). Dentist directory for the Delta Dental federal employees dental program. Web.

Thomas, W., Nasseh, K., & Vujicic, M. (2013). Financial barriers to dental care declining after a decade of steady increase. Web.

Yarbrough, C., Vujicic, M., Aravamudhan, K., & Blatz, A. (2016). An analysis of dental spending among adults with private dental benefits. Web.

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