Q-Dent Plan Membership Summary
THE Q-DENT PREPAID ADVANTAGE: The Q-Dent Dental Plan will contract with all dentists who are willing to participate, to provide dental services for their patients who are Q-Dent members. Prepaid dental plans are like HMOs (Health Maintenance Organizations) who contract with doctors to provide medical services for their members. A Q-Dent member pays a monthly premium. Each month, Q-Dent pays most of a member’s premium to a dentist who was participating before, or who was willing to participate after, being chosen by a Q-Dent member. The Q-Dent payments, called capitation (a uniform per capita payment of a fee per person), are paid monthly to a chosen dentist, though a Q-Dent member may not need monthly dental services. When a Q-Dent member needs dental services, Q-Dent’s capitation payments have been prepaid all or some of the cost of most dental services a member will generally need.
(NO CHARGE SERVICES). A member does not pay an extra charge to a chosen dentist for dental services that are fully prepaid by Q-Dent’s monthly capitation payments. The policy’s schedule of benefits list NONE on the same line that describes the policy’s fully prepaid dental services.
(CO-PAYMENT SERVICES). A member pays an extra charge (Co-Payment to a chosen dentist for dental services that are fully prepaid by Q-Dent’s monthly capitation payments.) The policy’s schedule of benefits lists the amount of the Co-Payment needed to cover the remainder of the cost for dental services that are not fully prepaid. The members pay all CO-PAYMENTS to the dentist the member chooses.
(USUAL CHARGE SERVICES). Most dental services a member will usually need are covered by the policy. In those cases when dental services are not covered by the policy, such dental services are also available to a patient at the chosen dentist’s USUAL CHARGE.
HIGHER BENEFIT LEVEL: For Q-Dent members, as patients of the dentist they choose, there are no deductible or annual maximums that apply to the benefits of the plan’s prepaid dental insurance policy. The policy’s benefits for pre-existing conditions, orthodontia for children and adults, and other specialist dental services are all available for the patients on the eligibility date of the prepaid dental insurance policy.
Q-Dent encourages utilization of the prepaid dental insurance policy by offering preventative treatments (such as periodic exams and routine cleaning twice per year) at no extra charge. There are no claim forms or pre-authorization forms for the patient or the chosen dentist to complete.
When compared to indemnity plans, prepaid dental plans offer more benefits for less cost, without any paperwork for a patient or the chosen dentist.
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