Is Ppo Dental Insurance Right For Me?
Dental insurance plans can be so overwhelming; how do you choose? Below are some common questions people have about PPO dental insurance. Compare this information with what you know of other plans available to you, and hopefully you’ll be able to reach an informed decision.
Q: What is PPO?
A: It stands for Preferred Provider Organization. Usually it’s offered to you through your employer, but it can also be offered to individuals through an insurance company. A PPO plan allows you to go to any doctor, not just one in the network. Your benefits will be greater if you visit a doctor within the network, but you will still get some coverage if you go outside the network. This is why it is called a Preferred Provider plan.
Q: So what’s the difference between a PPO and an HMO?
A: While individual plans can differ, he primary difference between a PPO and an HMO (Health Maintenance Organization) is the reliance on a network. With an HMO you are restricted to dentists on the provider list, including specialists. You will not be covered at all if you see a doctor outside the approved list of providers.
Q: How does PPO dental insurance really work?
A: This is a mystery to most people, but it’s really simple. The insurance company asks doctors if they’re willing to offer services for a discounted rate. In exchange, they send patients to that doctor (this is how you get a network of providers). The doctor gets a high volume of patients, which can be difficult to achieve on their own. You, the patient, then get the advantage of lower-cost services.
Q: Am I sacrificing good care for lower costs?
A: This is a highly debated question that centers around how the dentists are paid under the structure of each plan.
For example, in an HMO plan, the dentist gets paid a flat fee for every patient he or she sees. No matter what they do for you, cleaning or a root canal, they get the same payment from the insurance company. While this is great for the patient (you pay the same no matter what), for the doctor it can be trouble. Imagine you were paid the same amount no matter how much work you did or how high your expenses were. Wouldn’t you try to keep time and cost expenditures to a minimum?
With a PPO plan, however, the insurance company pays the dentist for actual services provided. This is why PPO plans can be more expensive to you than an HMO. The benefit, of course, is that there is no reason for the dentist not to give you the best care possible.
Q: Are PPO plans affordable?
A: Yes, especially when you consider the alternative! Any dental plan is going to be more affordable than paying full cost out of your own pocket. As mentioned above, PPO plans can be more expensive than an HMO plan. A PPO usually requires a deductible that you pay up front (versus the lower co-pay you have with an HMO). The amount of the deductible varies depending on your individual plan.
Hopefully this give you the information you need to decide. As always, check your individual plan options and compare the costs and benefits. Assess your health needs, your financial situation, and choose accordingly!
For free information and tips on full coverage dental insurance and dental insurance for seniors visit Buy Dental Insurance blog.
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