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PPO Insurances and the Importance of Dental Care Planning
A preferred provider organization, or a PPO, is a type of health plan that creates a network of participating providers. If your provider belongs to that plan’s network, you pay less. Other types of care plans, like HMO health insurance plans, only cover your care if the provider is in the network. PPO plans give you a larger selection of in-network care providers and will usually give some coverage for out-of-network providers. When it comes to dental care, being able to cover preventative services is key, as it keeps you from needing more extensive treatments down the line. Some of the benefits of a PPO dental plan include:
- Saving money
This is the simplest but most powerful reason patients choose a PPO plan. Because PPO plans work by developing a network of dentists, the dentists included charge lower fees than usual.
- Flexibility
A PPO dental plan allows you to choose from a variety of dentists in the network to select the one who is right for you and your family. While you are often able to visit an out-of-network dentist and still receive some coverage, you will save more if you choose a dentist within the network.
- Credibility
All of the dental offices in a given PPO dental network are required to meet specific credentials set by that insurance company. This gives patients some extra reassurance in knowing that their care provider met the set of requirements necessary to be a part of the network.
- No waiting for reimbursements
Because PPO dental insurance plans work directly with the in-network dentist, you won’t have to front the whole cost at the office and wait to be reimbursed.
- Discounts for complex services depending on the individual insurance plan
PPO insurance plans are not only helpful for covering preventative services. Many insurance plans also give patients the opportunity to receive discounts on complex procedures and orthodontic care. To find out what coverage you might have, it is best to contact your insurance provider directly, or contact our team and we can help you understand what steps to take.
How to Plan Your Dental Care for the Year
With a PPO plan, you usually owe a monthly premium and a deductible before your insurance activates for the year. For example, if you have a $500 deductible, you will be responsible for paying for the first $500 of treatment every year, but the average deductible is around $50 per year. After that, the insurance will kick in up to the limit of the coverage. With many plans, twice-yearly cleanings and other preventative services are fully covered, and the patient pays a percentage of the cost for more complex services like crowns and fillings. The American Dental Association recommends visiting the dentist for routine treatments regularly as determined by that individual’s dental provider. For most patients, this means scheduling visits twice a year, six months apart.
When it comes to planning your dental care with your insurance in mind, one factor to consider is the yearly maximum. This is the limit of the coverage your insurance will provide and tends to be around $1000 a year per person. Unused benefits do not roll over into the next year, so it is important to use the benefits while they are still active. If you get your treatments scheduled before the new year begins, it might still be possible to maximize your benefits from the current year. This is especially helpful if you need to have a procedure like an extraction or a tooth filling. Leaving those issues untreated will cost you more money and pain in the long run! Delaying your treatment to the next year also increases the possibility of the insurance fees rising. Making plans for dental treatments sooner will ensure that you are totally prepared for the cost and will not be subject to unexpected increases. A PPO plan is one of the many ways that you can access the dental care you deserve, and a little extra planning will go a long way for your smile and your wallet.
Want to learn more about how to get the most out of your dental plan? Call us at (714) 970-4560 or contact us online.