Introduction to American Dental Insurance
Dental Insurance At present, there are two types of dental insurance in the United States, which level of compensation and the annual limit of dental expenses, namely, the managed dental plan and the pay-per-service plan.
The managed dental care plan is a prepaid plan based on medical cost control, which controls costs by limiting the type, frequency, and power of reimbursement rates.
The core of the managed care model is that insurance and medical service providers become a community of interests.
This is also the root cause of the distributed medical insurance model to control risks and reduce costs effectively. The service-based payment plan is a post-payment plan.
The insurance company pays the price according to a certain percentage according to the expenses incurred by the dentist during the treatment process.
Managed dental care programs are further divided into Preferred Provider Network dental plans ( PP O), Dental Health Maintenance Organization (DMO or DHMO), or Capitation Plan (CP).
The service-based payment plan mainly includes dental expense reimbursement plan, dental discount plan and direct reimbursement.
2. American dental insurance representative products
(1) Aetna Inc. PPO products
As the largest dental insurance company in the United States, Aetna Inc. has designed different PPO products for Alaska, Arizona, Delaware, Illinois and Pennsylvania.
In Alaska, for example, Aetna Inc. offers two different PPO programs (see Table 1). Insured persons, there is a difference in the monthly premiums that policyholders are required to pay.
Among them, Plan A and Plan B are both 50-year-old, and they charge different premiums for young and old people. Aetna Inc.’s dividends are also showing an increasing trend depending on the type of insurance policy for individuals, couples, and families.
Source: Aetna Dental Insurance in Alaska: Aetna Individual PPO Plans
Also, the dental insurance includes preventive health services such as dental cleaning, X-rays, essential care services such as filling, tooth extraction, primary recovery, and first services such as gums, crowns, fillings, etc., as listed in the table.
(2) MetLife Inc. DHMO products
The dental insurance coverage provided by MetLife Inc. is similar to that of Aetna Inc., and will not be repeated. MetLife Inc. offers both PPO and DHMO types for free selection (see Table 2). It can be understood that the DHMO model provides a smaller coverage than the PPO, and the insured is also limited in the choice of dental care.
Source: MetLife TakeAlong Dental
Comparative Analysis of Representative Products and Development Status of Dental Insurance in USA.
1. USA dental insurance representative products
In comparison, China’s dental insurance started late. At the end of 2010, PICC launched the first domestic dental insurance -type medical insurance product in the form of primary coverage.
Marking the burgeoning of dental insurance in USA. According to the statistics of the USA Insurance Industry Association’s personal insurance product information database, until March 2017, there were about 20 dental insurance products sold online, and the coverage of these products was also small. Most of these products include only routine oral examinations and essential dental treatments. Representative products are as follows (see Table 3).
2. The development status and comparative analysis of China’s dental insurance market
- At present, China’s dental market is still in its infancy, with small market size and insufficient coverage.
- In comparison, the US dental insurance market is relatively well developed US dental insurance involves the prevention, treatment and cosmetic treatment of dental diseases.
- Among them, preventive items can be fully reimbursed, and therapy and beauty can be refunded. This reflects the importance of the US dental insurance prevention program for dental diseases.
- Effective prevention of dental diseases can reduce the risk of insurance companies paying for high dental treatment costs so that insurance companies can continue to develop.
- According to Table 3, at present, China’s dental insurance projects contain less
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