Dental insurance that covers everything #PPO #Dental #Insurance #for #Individuals, #Families #and #Businesses



Dental insurance that covers everything

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PPO Dental Insurance Plans

If your dentist told you to get PPO dental insurance because that is all they will accept, you are in the right place.

Take a minute or two and read this page. I will explain in layman’s terms how these plans work and what to watch out for. Of course you can always give us a call and we will be glad to guide you through all of this.

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.

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

You would think that all you need to do is find a PPO dental insurance and everything will be fine. The universe will be in perfect alignment.

Unfortunately, most people do not understand how these plans work and still end up with huge bills. When a dentist tells you that they will take any PPO plan, as opposed to a specific plan, what they really mean is:

“I am not a authorized network provider for every PPO dental plan. As a matter of fact, I might not take dental insurance at all. If I am not in the network or do not take insurance, I will charge you what I feel like for my work.

If I am in the plan’s network, I will give you a discount on all services because they hold my feet to the fire as to what I can charge you. You will probably save a lot of money over my regular rates.”

This is very important. The dental office that does not take insurance or is out of network is only going to submit the claim for you. Which means they will mail an insurance form to the insurance company. However, when the insurance company writes a check, they are basing it on their discount rates.

I know, that sounded a little confusing. A simple example will make this clearer.

Your dentist tells you that you need to have a root canal. They quote you $1,200. The dental office has told to get any PPO plan and that it does not matter which one. You have the work done, pay the dentist $1,200.

You are thinking that since your insurance plan covers 50% will send you a check for $600. But, that is not how it works.

When the check comes it is for $300. Why? Because if you had gone to a dentist in the PPO network, they would have charged you $600. That is the allowable rate. As a network provider they would not be allowed to charge more.

Remember, the insurance company pays out based on the network rate and not whatever the dentist feels like charging that day.

The lesson here is to try and find a provider that is in the plan’s network. I realize that some of you would not change to another dentist under any circumstances. Just be aware that your loyalty comes with a price.

A 60 Second Explanation on How PPO Dental Insurance Works

This might be a better example.

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


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