PPO Dental Insurance

There are very few PPO dental insurance plans that can be purchased by an individual. In most instances, the few available plans are poor choices for most consumers. Find out why.

You went to the dentist and now need a few crowns, root canals, bridges, etc. The bill will cost more than you put down on your home. You asked about dental insurance in the dentist's office and they told you they only accept PPO dental plans.

You call me up and I tell you that there are no plans you can buy and before I can help you with an alternative, you hang up and dial the next agent who will tell you the same thing. You continue to search the Internet until you manage to find someone who steals your money and cheats you blind.

PPO dental plans make the most sense when an
employer is paying for it. Otherwise they are expensive and generally return less benefit than their cost.

How a PPO dental plan works and why you probably don't want one

A PPO is a network of dentists who have agreed upon a discounted price for their services. Depending upon what you have done, the dentist will charge you a discounted rate and you will pay a percentage of the cost. This continues until you use up your allowance for the year. After that, it is open season on dental patients.

Keep in mind a few important points:

1. The plan has a cap or maximum payout each year. Generally, it is around $1,000 with some plans offering a little more and some a little less.

2. Once the cap is reached and you have used up your allowance, the dentist does not have to give you the discounted PPO rates anymore. They now have a cash customer who will pay full "retail" price.

3. They can easily use up most of your allowance with cleanings, x-rays, exams and a few simple procedures.

4. There is a deductible for each person of about $50 per year.

5. Major work, the expensive stuff is not usually covered until you have been on the plan for a full year. Then, they only pay 50% of the expense.

Now do the math. If a plan is charging you $35 a month for the premium and has a $50 deductible, you will spend $470 out of your pocket before you get back one dime from the plan. If you need a major procedure performed like a crown, it will not be covered until the second year.

At that point, you have paid out $940. A crown might be $600 with the discount of which you pay $300. This crown is starting to get very expensive and you have been suffering for 12 months because you had to wait a year before they would give you anything on it.

Wait, it gets better. Besides the crown you need a root canal. The dentist charges you the PPO rate of $500 of which you pay $250. Your crown and root canal are finally done and it only cost you $1590 including the deductible and last years premium. We did not yet factor in the second year premium. Good thing you had a PPO dental plan.

But I need a lot of work so the plan will really pay off for me, won't it?

Remember, when you use up the $1,000, the discounts stop. The crowns are now $800 or $900 each and a root canal - don't ask.

Are all plans like this?

No, we have some group plans that are cheaper (about $20 a month for an individual) and offer a bit more coverage ($1500 instead of $1,000). Plus, they have PPO discounts that continue even after the maximum amount is spent. This keeps the dentist honest.

The catch is that they your dentist might not be part of this particular PPO network. If you won't change dentists you can still take advantage of the plans and receive back up to $1500 a year on your dental expenses. In this case you pay your dentist, submit the invoice and get reimbursed.

We are trying to put together an individual PPO plan for approximately the same price. When it is available we will post it on this page.

Is it worthwhile? Let's look at an alternative

Discount dental plans will cost you about $8 a month, have no deductible, no waiting period for preexisting conditions and all major work is covered from day one.

A crown or root canal on most of these types of plans runs about $500. Cleanings, fillings, etc. are discounted up to 60%. Unless you are facing a tremendous amount of ongoing dental work, this type of plan wins hands down. Consider a family PPO dental plan costs up to $1200 a year and a discount plan about $150 a year. You can quickly see why PPO dental plans usually make no sense.

Want a free dental Plan?

Your dentist will only charge the discounted PPO rate when you are insured by a PPO dental plan. He or she obviously feels that the reduced PPO rates are just and fair compensation for their professional services. If they can get more it would be great but the PPO rates allow them to earn a substantial living. The PPO patient is happy, the dentist is happy, but you are not. You are still paying "retail" for his services.

A lot of you really love your dentist. You tell me what a great person he is, almost like a friend. Well, next time you are at your good old buddy the dentist, just ask him to charge you the PPO rate for all of your work. Why not? He gets fair compensation, cash at the time of visit and there is no paperwork or messy forms to fill out. I would love to be in a cash business with absolutely no receivables and no collections.

If your pal the dentist tells you he is not allowed to do it, then he is telling a fib and his nose will grow six inches as the words leave his mouth. If he tells you he won't do it, then maybe you are not really such good friends after all. It would probably be time to use one of the many dentists on one of our discount plans. Those dentist might not be become your best buddy, but they are not quite as greedy.