You may save money on dental care with a PPO plan because dentists in the network charge reduced rates. In contrast, non-network dentists charge higher fees. When choosing a plan, consider the monthly cost, the deductible and annual limits. Then, choose the right plan for your family.
Cost
When choosing a dental plan, you should consider costs. Most PPO dental insurance plans have lower out-of-pocket costs than HMO plans. This is because insurance companies work with dentists to build a network that offers discounts for plan members. The insurance company pays the dentist a predetermined amount for services, and then the dentist passes on the discounted rate to you. If you decide to go to an out-of-network dentist, the amount your insurance plan will pay is often based on an industry term called “usual, customary and reasonable fees.” When shopping for dental procedures, you should also consider the size of the dental networks. The bigger the network, the more likely you will be able to find your favorite dentist. DPPO plans tend to have a larger network than DHMOs, so you are more likely to get the best discount when visiting your preferred provider. Most dental insurance plans have a deductible that you must meet before your insurance will begin to cover costs. The deductible is a dollar amount you must pay each year before your insurance contributes to costs. Typically, a deductible is applied to all types of care and is not specific to dental treatment. The exception is preventive care, which is generally covered with no deductible.
Coverage
Dental insurance is designed to cover some of your family’s oral health costs. Different dental plans exist, including PPOs, HMOs and indemnity dental plans. Each type of plan works differently regarding out-of-pocket expenses, coverage and savings. With a Preferred Provider Organization (PPO) dental insurance plan, the insurance company has negotiated a list of dentists agreeing to charge fees lower than usual. The insurance company then pays a portion of the total cost, which means you spend less. You still have the flexibility to visit any licensed dentist. Still, you will likely be required to meet a deductible and annual maximum before your plan begins to contribute to covered procedures. For a less restrictive choice, consider a DHMO plan. These dental health management organizations only allow you to receive care from a dentist contracted with the insurance company. Still, they generally offer lower rates and don’t require specialist referrals. To help you compare costs and options:
- Create a generalized list of your family’s oral health needs based on past patterns.
- Calculate what you expect your yearly fees to be. This will give you a good idea of what is available in your budget and the value of various plans.
- Consider preventive care and the potential for major procedures, such as braces, in your estimates.
Flexibility
Dental insurance plans offer various coverage options that vary in cost and flexibility. They also come in multiple forms, including group and individual plans, and they can be purchased directly from providers or acquired through employers. It’s important to do homework to understand which coverage options are best for you and your family. The most common types of dental insurance are preferred provider organization (PPO) and health maintenance organization (HMO) plans. PPO plans offer more freedom and a wider selection of dentists than HMOs, but they can be expensive and may have higher out-of-pocket costs. Many individual DPPO plans offer a 100/70/50 coverage formula that pays for preventive procedures like checkups and cleanings at 100% (you typically don’t have to pay a deductible) while covering basic functions such as fillings at 70% and major procedures like crowns at 50%. If you have a preferred dentist, consider checking whether they are part of the insurance network. You’ll likely get the most cost savings by visiting in-network professionals. You can also find various plan options that include features such as Maximum Rollover benefit, which lets you keep portions of your annual maximum that you don’t use if you need additional procedures. Other benefits can include flexible coverage amounts for different functions, such as orthodontics or teeth whitening.
Convenience
If you are considering getting PPO dental insurance for your family, doing a little research before making any decisions is important. Start by evaluating the plans available in your area or offered through your employer. Then, look at what each plan covers and how much it costs. Consider the deductible and annual maximums (a cap on how much a plan will pay in a given year). Finally, make a list of your family’s current and projected needs for dental care. This will help you better compare and contrast options. When comparing plans, look for companies that offer large nationwide networks. This will give you the cinewap highest likelihood that your preferred dentist is in-network and will result in significant savings. Also, ask the insurance company about their care agenda and how they are helping you reduce your overall cost of care. There are two main types of dental insurance plans – Preferred Provider Organization (PPO) and Dental Health Maintenance Organization (DHMO). A DPPO allows you to choose your dentist but usually pays less if you go to in-network dentists. DHMOs, however, require you to see only in-network dentists. However, they have generally lower costs and a simpler fee structure.