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PPO Dental Plans

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. So begins your quest for the "holy grail" of dental insurance - the PPO dental plan.

If you are seeking group style PPO dental insurance as an individual, you are going to be a bit disappointed. But, we might have some workable solutions for you that will save you money in the long run (and the short run). Please take two minutes and read through this page.

Here are the basic questions you need to be asking:

1.
What is a PPO dental insurance plan?
2.
What do PPO dental plans cover?
3.
Does it really make sense to buy a PPO dental plan?
 
4.
What are PPO-Style Plans?
 
5.
How can I get a quote and compare information on different plans?

If you give me a few minutes and I will help you answer each question and find the perfect plan to meet your personal circumstances.

“My dentist told me to find a PPO dental plan.”

We hear this statement every day. If your dentist knew of a plan he or she would accept, they would have already mentioned it. To be candid, I do not think they or their office staff have a clue as to what plans will accept individuals.

Let me save you some time: We do not know of any true PPO dental plans that you can buy unless you are part of a group plan. But, we do have a few PPO-style plans that have large networks of dentists.

What is a PPO Dental Insurance Plan?

A PPO consists of a network of dentists who have agreed upon a discounted price for their services. Depending upon what procedure is being performed (filling, cleaning, etc.), you will only have to pay this predetermined discounted rate.

The plan will pay for a percentage of this discounted rate and you will pay the rest. A typical plan might look something like this:

Service Plan Pays You Pay
Preventative Services (cleanings, x-rays, etc.) 80 -100% 20 - 0%
Basic Services (fillings, minor extractions) 50 - 80% 50 - 20%
Major Services (crowns, root canals) 20 - 50% 80 - 50%

It all depends on the plan. Plus there is a cap on the total amount the insurance company will pay per person per year. This varies from $750 to $1500 per annum, per person. After that, it is open season on dental patients.

The dentist does not have to honor the PPO rates after you use up your annual limit of coverage. Although, he or she would be a real bastard if they decided to charge you full price and drop the discount.

Clearly, if you need many thousands of dollars worth of dental work, you are going to pay a good portion of it from your own pocket.

What Does a PPO Dental Plan Cover?

The services for most plans are divided up into three categories:

  1. Preventative Services – exams, cleanings, x-rays, etc.
  2. Basic Services – fillings, spacers, minor repairs
  3. Major Services – root canal, crowns, more difficult extractions, etc.

Most dental plans (every type) do not cover major services until you have been on the plan for at least 12 months. The exception is a discount plan.

Do I Really Need a PPO Dental Plan?

PPO dental insurance is not a great value. But,it can be worthwhile under the following circumstances:

1. It is the only type of plan your current dentist will take and you refuse to switch dentists
2. You are going to have a lot of work done and “max out” the benefit.
4. Somebody else (i.e., an employer) is paying for the plan.

Otherwise, the cost-benefit is questionable. We have indemnity plans that can be matched with national discount networks that will essentially do the same thing for less money.

PPO Style Plans and Other Alternatives

Discount Networks

Discount dental plans cost between $7 and $12 a month, have no deductible, no waiting period for preexisting conditions and all major work is covered from day one. Of course, it provides just a discount.

A crown or root canal on most of discount plans runs about $500 to $550. Cleanings, fillings, etc. are discounted up to 60%. Unless you are facing a tremendous amount of ongoing dental work, a discount plan wins hands down. If you consider that a family PPO dental plan costs approximately $1,200 - $1500 a year and a discount plan about $175 a year. You can quickly see why PPO dental plans are not always the best choice.

PPO Style Plans

If you want PPO benefits but do not want the limitations of a PPO plan, you should consider combining an indemnity plan with a good discount network.

To keep this simple, an indemnity plan pays you or your dentist fixed amounts for various procedures. So, the plan might pay you $35 for a cleaning (which might cost $35 to $40 in network) or $200 for a crown and so forth.

By the way, if a crown has a discounted rate of $500 and you get $200, it is costing you $300. With a PPO plan they usually pay 50% on crowns and you are paying about the same.

We have an excellent plan that:

- Uses the Ameritas dental network (a very large national network of dentists)
- Includes the VSP Vision plan with $10 co-pays for eye exams

For a direct link to this plan: http://www.aabbenefits.com/?Agent=3sm27HhE2utE7ffgCbB3

When you get to the site, click on Dental Plan on the left. It is $24.95 a month for an individual and $54.95 for a family of 2 or more. To enroll, use the ENROLL TODAY button top left. You will also be able to look up providers.

For quotes on any of our dental plans, go to our dental plan quotes page now.

If after reading through the web site you find it confusing or not clear, by all means give us a call at 954-757-0033 and I would be more than glad to help you.

If you cannot find your dentist on any of the plans we offer, it simply means that your dentist does not accept any of the plans we offer. There is nothing we can do except tell you to find a new dentist.


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