Compare Recent Competitive Quotes From A Typical Dental Plan Fee Schedule
First Step: What Exclusions Apply To About Every Dental Plan Fee Schedule?
If you’re not familiar with the variations that you can find on a typical dental plan fee schedule, each plan has it’s own allowances (exclusions) as to what they will pay. (Continued After Table...)
| CATEGORY | DESCRIPTIONS | FEES | METRO AREA | STATE |
|---|---|---|---|---|
| DIAGNOSTIC | D0120 Periodic oral evaluation | $33 | National Sample | NA |
| DIAGNOSTIC | D0150 Comprehensive oral evaluation | $53 | National Sample | NA |
| DIAGNOSTIC | D0274 X-Ray: Bitewings-4 films | $49 | National Sample | NA |
| PREVENTIVE | D1110 Prophylaxis-adult | $58 | National Sample | NA |
| RESTORATIVE | D2140 Amalgam filling-1 surface, primary or permanent | $88 | National Sample | NA |
| RESTORATIVE | D2330 Resin-based filling composite 1 surface, anterior | $108 | National Sample | NA |
| RESTORATIVE | D2750 Crown-porcelain fused to high noble metal | $760 | National Sample | NA |
| ENDODONTICS | D3330 Molar (excluding final restoration) | $780 | National Sample | NA |
| PERIODONTICS | D4341 Periodontal scaling and root planing, 4 or more teeth, per quad. | $181 | National Sample | NA |
| PROSTHODONTICS | D5110 Complete denture-maxillary | $850 | National Sample | NA |
In effect all dental insurance and reduced dental fee plans attempt to provide discounts on dental services. These can be dental discounts for both prevention (cleanings, xrays and dental examinations) or discount dental services in restorative areas like crowns, fillings, bridges and even discounted dental implants.
The two major types of plans are:
1. Insurance, which is most often subsidized by an employer, and individual insurance
2. Alternative discount dental plans, which are not an insurance-based product.
Here's a real world example of the type of reductions from a typical dental fee plan schedule that can be achieved. The following is a common procedure, in effect a simple "silver" or amalgam filling, done on only one side, or one surface of the tooth. The first number is the dental billing code that is given to the insurance company. The first price is one given from a practice in Arizona that is a full fee, or non discounted fee that could be found on a common dental fee plan schedule. The second rate is the discounted number from a typical discounted dental fee plan.
Code...............Procedure...............Full Dental Fee................Discounted Dental Fee
2140...............AMALGAM-ONE SURFACE, PRIMARY OR PERMANENT...............$94...............$47.00
Does A Discounted Dental Fee Plan Schedule Cover Pre-Existing Dental Conditions?
There are a long list of pre-existing dental conditions that a dental insurance program may not cover but which would be treated under a discounted dental fee plan. For example, a missing tooth is a condition which is often excluded under either individual or employer-based dental plans.
And no matter what the particular cause of this type of dental problem, it's rare to get any coverage on a typical insurance-based dental plan fee schedule. (It's conceivably possible to gain coverage if it somehow can relate to treatment of an overall medical condition, although in the case of a previously missing tooth, not often heard of.)
The key is that most discount dental fee plans allow someone to schedule just about any type of named treatment, without worrying about the cause. Since it is a true discount plan for dental, there's really no limit to how much dental work can be done as long as it's paid for at the time of service, or through some type of dental financing plan.