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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:
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:
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:
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) 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. |