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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. There are vast armies of dentists that are sending their patients on to the Internet to search for a PPO dental plan. But, once you begin to look and make calls, you cannot find any. Most of the PPO dental plans are geared towards groups. 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 be responsible for 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? If you are seeking a dental insurance plan that will cover most of the cost of your dental work, you are going to be disappointed. If you just read the preceding paragraph, you already know that. The services for most plans are divided up into three categories:
Some plans have a fourth category for very extensive procedures and others will have a separate but limited benefit for orthodontia. Although, the plan does not usually pay more than 50% for major procedures, the annual allowance can go a bit further than you might expect. If a root canal has a PPO discounted price of $500, the plan will pay $250 and you pay $250. At this rate, you should be able to get through some crowns, root canal and fillings. For the average person this should be adequate. In addition to the annual limits we already mentioned, there are waiting periods. This is a very important fact to keep in mind. These waiting periods can be from six months to two years and are usually applied to Major Services. So, do not expect to purchase a plan and have coverage for your root canal and crown next month. Do I Really Need a PPO Dental Plan? To be candid with you, at times, 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 Dental Insurance 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 word about dental networks - There are some discount networks that have extensive coverage. Many of them replicate PPO networks. The networks that come closest to PPO networks, do not offer as deep a discount. So, a root canal using one network might cost $480 while the other might have a discounted rate of $580. Always keep in mind, that the discount cards provide the deepest discounts for a general dentist. If you use a specialist, look for the fine print. The discounts for specialist are 20 - 25%. A crown or root canal on most of discount plans runs about $500. 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 a year and a discount plan about $175 a year. You can quickly see why PPO dental plans are not always the best choice. Hybrid 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. We have approximately 30 different networks that you can choose from. The rates you will pay at a general dentist is comparable to the PPO rates for services. Specialists in the network will discount at around 20%. The indemnity plan will pay you fixed amounts for various procedures. There will still be a 12 month wait for major services. Our Select Dental Plan is a perfect example of this combination. For quotes on PPO dental insurance and other plans, go to our dental plan quotes page now. |
