The Oral Health Care Program(s): An Explanation
This Dental Benefit Program is a program whereby employers, families, individuals, and groups realize savings for dental treatment because of lower dental fees, resulting from group participation. It is a program offering good quality, comprehensive, preventive dentistry at affordable fees for you , the dental consumer. You will be joining a benefit club designed and administered by dentists. Yes, OHC gives you the opportunity to choose something better than traditional insurance.*
This program was designed to make preventive dentistry and treatment easier and less expensive for you, the dental patient and consumer. There are many advantages over traditional dental insurance. It is a program open to any dentist who wants to sign an agreement and join. You receive your dental treatment by an independent contracting dentist in his or her own personal dentist office. This program places emphasis on prevention, which is in your hands to lower your oral health care costs. Even if you as an employer have a current dental plan, we just ask that you make our plan available.
The most desired and needed employee benefit program required today is dental benefits, and we want to work closely with you to lower your dental bills and dental illness days off from your job.
Many Advantages of Oral Health Care's Dental Benefit Program Over Traditional Insurance, or Other Plans**
- The dental care delivered by the independent dentists for diagnostic and preventive benefits is almost always 100% no charge to you at the appointment time. This includes oral examinations, diagnosis , case presentation and treatment planning, full mouth series of x-rays and bite-wings, prophylaxis or polishing, and fluoride treatments. Approximately 60% of the most commonly performed dental procedures are at no charge on this program.
- There are no claim forms to file, meaning much less paperwork for you, your employer, and the dentists, and OHC has been in business over fourteen years!
- There are no deductibles to pay per person or per family per year.
- No medical or dental examinations are required to enroll. Everyone is accepted and approved.
- There are no waiting periods to begin benefits such as for crowns, bridges, partial dentures.* You may receive immediate benefits upon receipt of your enrollment form!
- You have many benefits per year with no maximums and no usage limits.
- You may not be cancelled for over utilization (or over usage) of this program.
- Pre-existing conditions do not effect your availability of benefits, and are covered!
- A fee schedule is available and lists the amounts you should expect your cooperating dentist to charge in co-payment.* By allowing your dentist to collect co-payments for certain more complicated procedures, the dentist has more incentive to practice more comprehensive, quality dentistry.
- Part-time employees are eligible to enroll.
- No predeterminations are required or suggested for your treatment plan. You have to deal and communicate only with your personal plan dentist. You are not involved in a triangle with an insurance company. There is no waiting on payment for claims by an insurance company and then finding out that they did not pay like you thought they would!
- You receive the best treatment plan recommended by your dentist. There are no basic or optional treatments in this plan like dental insurance sometimes has.
- OHC has no five year exclusion on replacement bridges, partial dentures or dentures. Some insurance companies will only allow replacements once every five year period.
- While most insurance companies disallow or will not pay on the usual non-covered benefits, the OHC cooperating dentists will give you a lower fee of at least 10% off their usual, reasonable, and customary (U.R.C.) fee for procedures not listed in the Plan as a benefit.
- The Maxi-dent Plus Plan delivers benefits for TMJ treatment and cosmetic dentistry (most other plans exclude this). This Plan has broader, more comprehensive benefits.
- Preventive dentistry control benefits and instructions on proper oral hygiene are available at no charge to you at the appointment time.
- There are no underwriting requirements, such as:
- No percentage requirements for an Employer's company to enroll;
- If a single individual marries, then he or she can update to a family status by paying additional club dues per dependent;
- If someone has family benefits and becomes separated or divorced, then he or she may update to a single or other status by notifying the OHC Home Office;
- An individual within a family, may receive benefits on a single status if a spouse (or a husband and wife) have a traditional insurance or other plan, but that family may not receive benefits twice.
- The dentist will deliver fluoride topical preventive treatment to adults with no age limits at no charge to you at the appointment time (most insurance companies stop coverage at age 19)
- The dentist will deliver a full mouth series of x-rays to you each and every year (when recommended by your dentist) at no charge to you at the appointment time. Most insurance companies provide this only once every two or three years. In this way, the dentist can give you a more complete and better treatment plan, finding disease in its incipient stages!
- The dentist will deliver bite-wing x-rays (when required or recommended by the dentist) at no charge to you at the appointment time, and not just every six months like most dental insurance companies.
- We have no employer co-payment requirements.
- You will be automatically renewed each year simply by paying your monthly club dues and/or allowing your bank draft to clear.
- We do not want to just maintain your dental health like the HMOs. We want to improve and restore your dental health.
- This program is portable and if you become ineligible for benefits through your employer or group plan, you may convert to an individual basis by notifying the OHC Home Office.
- In your area, we will usually have more cooperating dental offices because the dentists like the OHC Program much better than other plans. We believe this professional Dental Benefit Program, designed and administered by dentists, can offer a higher quality of dentistry to you! Also see our many Bonus Benefits for joining, such as optical and pharmacy discounts!
*See Exhibits **See Limitations
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