A PPO dental insurance plan will provide you with more freedom to choose your dentist than an HMO dental plan. You will be able to seek dental services from a wider selection of dentists and may visit any dentist or specialist within the PPO network. However, unlike a traditional dental insurance plan, you will still not have the complete freedom to use any dentist of your choice. A PPO dental plan will provide you with a list of participating dentist. All of the dentists on this list will have a contractual agreement with the dental health insurance company to provide services at negotiated rates to any member of the plan.
With a PPO dental insurance plan you will usually have a deductible and a coinsurance amount. This is similar to an indemnity dental insurance plan, but the fees that you pay are based on lower negotiated rates. You will not need to worry about paying for excessive charges from your dentist because they have a contractual obligation to provide services at a set rate, but you will have to meet the annual deductible requirement before you begin receiving coverage. Once the deductible has been met, you will continue to pay a share of cost for covered services (coinsurance). The percentage you pay for coinsurance will vary from one plan to another and depend on the type of dental care you receive.
In some cases, PPO dental plans will give you an option to seek dental treatment outside of the directory of dentists. If your PPO dental plan provides this option, you will most likely be required to pay a higher coinsurance and your maximum payable benefits amount may also be greatly reduced for treatments outside of the network. You should consult your dental plan's covered benefits section to find out whether this option is available to you.
Similar to the HMO dentist, a dentist that accepts PPO dental insurance members will do so in an attempt to establish a patient base. Since the dentist is paid by the insurance company for each service performed, his compensation will be higher than that from an HMO dental plan, but he is still obligated to perform services at a discounted rate.
Before choosing a PPO dental insurance plan, make sure that there are dentists available in your area that accept the plan. The dental insurance company should provide you with a directory that will list all of the participating dentists in your county.
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