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PPO Dental Insurance

It can be difficult to decide which type of dental insurance to get, particularly when you don’t have a clear sense of the intricacies of each type of dental plan. We’ll explore PPO dental insurance in detail, giving you an insight into the plan’s treatment coverage, financial breakdown, benefits, and disadvantages and how to utilize it effectively:

Overview

So, what is PPO dental insurance? PPO – meaning ‘preferred provider organization’ – refers to a dental plan which give you access to a pre-existing network of dentists. This gives you the opportunity to utilize country-wide dental care, ensuring a high degree of freedom when it comes to your treatment options. You can see a dentist outside of your PPO network if you want, however, you will have to pay a higher rate for your treatment.

Coverage

PPO dental insurance generally covers an extensive range of dental treatments, including:

  • Preventative and diagnostic procedures – routine exams, routine x-rays, fluoride treatments and cleanings.

  • Basic procedures – fillings, non-surgical extractions, periodontal scaling, emergency treatments, anesthesia, non-routine x-rays and palliative treatment.

  • Advanced procedures – gum disease treatment, dentures, crowns, surgical extractions, root canals, oral surgery and bridges.

PPO plans will often have numerous exclusions, such as dental injuries that are not covered.  In most cases, braces will not be covered by PPO dental insurance. If you want braces covered by your dental plan, you’ll probably need to pay a little bit more. Other exclusions can exclude pre-existing dental conditions, injuries sustained from your work environment, and other cosmetic dental treatments such as teeth whitening.

Financial

With a PPO dental insurance plan, you pay a monthly premium that is normally slightly higher than other types of dental plans, such as DHMOs and indemnity plans. Whenever you need to make a claim, you’ll pay a co-payment (although preventative and diagnostic treatments are entirely covered by the plan). In addition, there’s going to be an annual limit to the amount that you’re able to claim. This figure will vary substantially from plan-to-plan, and if you think you’re likely to claim regularly, it may be worth seeking out a PPO plan with a higher limit.

PPO dental insurance plans also have a deductible, which is the minimum amount that needs to be paid for the PPO to kick into gear. For example, if a procedure costs $150 but your plan’s deductible is $200, you’ll have to pay the entire cost of the treatment yourself.

Benefits

As one of the most popular types of dental plans, PPO dental insurance has a wide variety of benefits. Most important, however, is the flexibility of this type of plan, which means that your treatment options aren’t limited by geographic location. If you’re a frequent traveler, a PPO plan can ensure that you stay protected wherever you are.

Disadvantages

A PPO dental insurance plan will generally cost more in premiums than other types of dental plans, which can be a problem for more budget-conscious individuals. If you don’t travel very far outside your local area, a DHMO plan may be a more appropriate option for your needs.

Process

So, how do you make a claim with a PPO dental insurance plan? It’s simple. In the majority of cases, the PPO dentist will handle all the paperwork for you, so you won’t need to pay the entire fee and wait to be reimbursed. Instead, you’ll just need to pay the co-payment. Before you receive treatment, it’s always worth speaking to your dentist so that you can get a clear picture of what the costs of each individual treatment option work out as. Different treatments cost different amounts, which can have an impact on which one you choose, so it’s best to stay aware of all the different options available to you.

Need to book an appointment with a PPO dentist? Get in touch with 1-800-DENTIST, and book an appointment with a local PPO dentist on the very same day.