5 Things You Should Know About PPOs
Dental Insurance Tips from DentalInsurance.com: 5 Things Consumers Should Know About PPOs
Interest in dental preferred provider organizations (PPOs) is on the rise. Learn 5 things the experts at DentalInsurance.com want every consumer to know about this popular type of dental insurance plan.
Los Angeles, CA: March 25, 2013
DentalInsurance.com, the preeminent online exchange platform for dental insurance plans and discount dental plan comparison shopping, enables consumers to compare, apply for, and purchase dental insurance and discount protection from top-rated insurance carriers online via the company’s website at http://www.dentalinsurance.com. With interest in dental PPOs, or preferred provider organizations, growing, both among consumers and dental care providers, the Company today is sharing information with consumers about what PPOs are and why consumers might consider joining one.
5 Things Consumers Should Know About PPO Dental Insurance Plans
1. How PPOs work. A preferred provider organization is a type of dental insurance plan in which individuals select their dentist from a network of dental professionals (the “preferred providers”). Participating providers agree to provide dental care to the PPO’s members at reduced rates. Consumers who participate in PPO dental plans select a dentist from among the group participating in the PPO (an “in-network provider”), and they are assured in advance of the maximum cost of their dental treatment.
2. PPO dental plans help restrict costs for oral care. A PPO plan provides the opportunity to reduce out-of-pocket costs by using an in-network provider. The dentists who participate in a PPO’s network have agreed to pre-negotiated fees. Because the participating dentists agree to charge less than their usual fees, consumers save money.
Because the participating dentists agree to charge less than their usual fees, consumers save money.
3. Consumers pay lower, pre-negotiated prices. PPOs operate with a calendar year maximum for covered individuals, a deductible, and waiting periods for certain procedures. However, even after reaching their annual maximum or exceeding the number of cleanings available each year according to the terms of the plan, consumers with PPO dental insurance can pay the lower, pre-negotiated prices when they see an in-network dentist.
4. PPO patients are assured in advance of the maximum cost of their dental treatment. Access to care at the lower, pre-negotiated prices can mean big savings when patients receive additional services because they are not subject to the full costs dentists would charge patients without insurance. Patients should examine in detail any restrictions on the types of treatment that participating PPO dentists are willing to provide.
5. Depending on the carrier, a PPO may provide the freedom for consumers to select an out-of-network dentist. However, be aware that patients who do so also pay higher co-payments. If a PPO subscriber chooses to see a dentist who is not part of the dental network, some PPO plans will pay based on a concept known as usual, customary, and reasonable fees, or “UCR.’ However, most will pay the out-of-network dentist the amount the insurance company would have paid an in-network dentist for the same services. The customer is responsible for the remaining balance (the difference between their dentist’s charges and claims paid).
“No single type of dental insurance plan will provide the perfect solution for every consumer,” DentalInsurance.com Director of Business Development Avery Smith notes. “However, if a PPO dental plan meets the needs of individual consumers better than other alternatives would, then a PPO plan may be the most sensible option. DentalInsurance.com provides an exceptionally easy-to-use platform for online dental insurance comparison shopping. In addition, consumers can also find thorough information and answers to their questions about dental insurance and oral care using the Dental Resources section of the site.”
Based in Los Angeles, CA, DentalInsurance.com has been the preeminent online exchange platform for dental insurance and discount dental plan comparison shopping since 2001. A leading innovator and provider of dental insurance and discount protection to individuals and employers, DentalInsurance.com was the first company to enable consumers to compare, apply for, and purchase dental insurance and discount protection from top-rated insurance carriers online via the company’s website at http://www.dentalinsurance.com. Working diligently to deliver the most competitive carriers and plans nationwide, DentalInsurance.com provides individuals, families, and businesses quality dental coverage to fit every budget and lifestyle.