Getting a Dental PPO Plan? Heres What That Actually Means

Like any other industry, the dental health plan world is chock full of terms and acronyms that you’ve probably never heard of. One of the most popular is “PPO” – as in a dental PPO plan. But what does that actually mean? And what can you expect when you sign up for one of these plans?

PPO stands for “Preferred Provider Organization”, and it can apply to an individual dental insurance plan or a family plan. In either event, a dental PPO plan means that your insurance company gives you a list of approved dentists – also known as their “preferred providers”. As long as you go to any of the dentists on that list, the treatment and services that you get will be covered, according to the terms and conditions of your policy.

But what happens if you go to a dentist that isn’t on that list?

If you opt for a provider who’s not on the list, you’re going to what’s called an “out-of-network” dentist – and the insurance company may not pay your claim. Instead, you may be responsible for all (or a big portion) of the bill. All of a sudden, that discount dental plan you signed up for can be awfully costly if you decide to get treatment out-of-network!

Luckily, the big dental health plan companies have long lists of approved providers. In fact, the dentist you’ve been going to for years may be on there! If you’re going to go with a dental PPO plan, it’s best to find one that comes with a big list. Otherwise, you may not be able to find a dentist in your area, or one that can see you right away.
If you’re limited by this list of providers, why is a dental PPO plan so popular?

Individual dental coverage isn’t very expensive to begin with, but working with a company that has a provider list can save you a good chunk of change. Here’s how:

In order to be on the insurance company’s provider list, each dentist has to agree to perform services and treatments for a set price that’s lower than what the dentist would charge if you were to simply walk in for an appointment without insurance. In exchange for providing lower rates, the dentist will get exposure on an insurance company’s PPO list – giving him business in bulk.

Since your insurance company won’t have to pay as much for the services you get, it can pass those savings onto you – in the form of lower monthly premiums and even lower deductibles. It makes a discount dental plan even more affordable!

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