New Rules for Dental and Vision Plans: Protecting Doctor Choice and Fees.
This bill increases the independence of dentists and optometrists by limiting insurer control over their practice. Doctors can charge their standard rates for services not covered by the plan, and plans cannot dictate the choice of laboratories or suppliers. For citizens, this means clearer rules on out-of-pocket costs for non-covered services and protection against full charges for dental cleanings exceeding annual limits.
Key points
Doctors can charge their usual rate for dental or vision services not covered by the insurance plan, instead of being forced to use the discounted network rate.
Insurance plans cannot restrict doctors' choices of laboratories or suppliers for materials and services provided to patients.
For dental cleanings, even if the annual maximum is exceeded, the dentist can only charge the contracted network fee.
Agreements between doctors and limited scope plans lasting longer than two years require the doctor's explicit acceptance for each extension.
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