Discover Dental Care Individual Benefit Plan
The Discover Dental Care (DDC) Plan’s core focus is to facilitate the delivery of affordable, excellent and predictable patient care outcomes in Oral Health for its participants. Discover Dental Care is operating as an Independent Practice Association which has been created by a dentist to provide a structure to enable the majority of dollars to go to the Dental Provider member practices. The goal is to provide affordable, excellent dental care in a state of the art facility, and incentivize patients to achieve and maintain high levels of oral health.
In contrast, dental insurance companies have a clear primary mandate to generate increasing profits and partner with brokers and third party administrators to control an established structure to direct a predetermined amount of premium dollars for patient care. The percentage of the premium dollars available for treatment has a wide variance and can range from 8 to 20%. The available funds to provide treatment directly to the provider, are generally not sufficient to maintain quality care. Contracted fees can be as much as 60% lower than usual fees.
DDC Benefit Plan Highlights
100% coverage for routine preventive and diagnostic services**
70% coverage for basic restorative (fillings), surgical treatment (simple extractions), laser treatment, and miscellaneous adjunctive services.
50% coverage for major restorative (crown, bridge, denture), oral surgery, endodontic (root canal), and periodontic (gum treatment) services.
50% coverage for cosmetic services (teeth whitening, porcelain veneers, and cosmetic bonding).
$50 annual deductible per person (max 100 per family) applies to all services except preventive.
$2,500 annual maximum for all services.
Accumulated Carryover of unused $ limit for 2 consecutive yrs, to capture a maximum of $5,000 in the 2nd year and complimentary in-office Sinsational Smile Whitening provided the patient completes a minimum one preventive visit and completes any required deep cleaning within the first year to maintain healthy gums.
*Dependent coverage to age 21 with an exception to age 25 if in school.
**Percentages are applied to the maximum allowable UCR — Usual, Customary, Reasonable fees for the region, as determined by Tracy Dental Excellence
Compare to Insurance
Where do the fees go?
- Easy to understand
- High-quality care with state-of-the-art technology and facility appointments 7 days of the week. Emergency and walk-in, same-day emergency treatment.
- No estimate requirements
- No waiting period for treatment options chosen
- Typically all services are covered other than implants and orthodontics, but including cosmetics
- Ability to experience a complimentary initial exam, X-rays, photos and cleaning
- Survey for what is working and what is not with existing benefit plan
- Preferred Status as a top tier patient of the practice
- Affordable financing options for co-pay fee
- Future utilization of existing medical insurance for eligible dental procedures
- Specialist referral treatment coverage, coordinated through the main provider to ensure the quality of care
- Dependent coverage to age 21 with an exception to age 25 if in school
- Treatment decisions are made between the dentist and patient
- Dentist-patient relationship is enhanced
- No submission of X-rays, or pre-determinations
- Typically all services are covered other than implants and orthodontics
- No confusing exclusions such as alternative benefit provisions, pre-existing conditions, downcoding, multiple treatment reimbursement reductions
- No waiting periods
- The cost of practice operation is reduced, enabling more investment in high-quality care
*The Discover Dental Care benefits program is a membership plan only available through Discover Dental Care, LLC exclusively for our paid member patients, and services must be provided by our member practices. The Discover Dental Care Benefit Plan is not an insurance benefit plan.