Choosing the right dental insurance plan is about knowing the pros and cons of your choices and considering your individual needs and those of your family. One of the most common dental insurance plans is PPO dental insurance.
Below, we’ll help you better understand this dental plan to help you pick the best one for your and your family’s needs and avoid costly, unplanned medical bills.
PPO insurance involves a group of medical facilities and providers under contract with an insurance company to provide low-cost services.
A PPO plan covers all healthcare services offered by medical facilities and practitioners within the network.
PPO subscribers aren’t required to choose their primary care provider or have referrals to receive treatment.
PPO dental insurance plans cover costs of primary care, major restorative dental care, and preventive services.
PPO insurance offers subscribers access to a more extensive network of dentists and other healthcare specialists.
You’ll find higher premiums, deductibles, and copayments in a PPO than in an HMO dental plan.
No waiting period in PPO dental insurance plans means patients can receive different dental treatments on the exact same day.
PPO (preferred provider organization) is a type of health insurance plan that involves a national network of medical providers (doctors, hospitals, etc.) contracted to a health insurance firm to provide affordable treatment.
A PPO is a type of managed healthcare insurance plan that’s similar to a health maintenance organization (HMO), point-of-service plan (POS), fee for service (FFS), high-deductible health plan (HDHP), and exclusive provider organization (EPO).
If you get treated by an in-network dentist, you’ll pay less [1]. You can use a dentist outside of the network at an extra cost.
You will likely have to pay an annual deductible before the insurance provider starts paying your medical bills. Moreover, you may need to copay for some treatments or pay a certain fraction of the total cost of your medical bills.
A PPO plan covers all the treatment provided by dentists within the PPO network. Referrals aren’t required to see a network dentist, and subscribers are encouraged, rather than required, to choose their primary care provider. Subscribers can receive dental insurance coverage out of the network, but it typically costs more.
PPO insurance covers all types of dental treatments provided by dentists in the PPO network at a discounted price. You don’t need to choose your primary care provider or have a referral to get treatment. PPO also allows you to receive treatment out of the network, but you’ll have to pay more.
PPO dental insurance covers the costs of preventive care services such as oral exams, certain X-rays, and routine cleanings. It also covers basic care procedures like fillings, non-surgical extractions, and emergency treatment for pain relief. Preventive dental services have no waiting periods.
Before you sign up for any PPO dental plan, be sure to go through the details of the plan’s coverage, like out-of-pocket costs, limitations, exclusions, annual maximum, and potential waiting periods.
PPO dental insurance provides coverage for preventive, primary, and major restorative dental services. These services come with different limitations, costs, and possible waiting periods.
PPO offers subscribers a broader network of dental facilities and dental specialists. This plan doesn’t restrict you to one primary care dentist, meaning you can see a dentist without a referral [2].
Therefore, PPO is a great option for those who want extra flexibility when selecting their dentists, those who need to visit dentists regularly because they suffer from chronic dental problems, or people who travel often.
What We Like
What We Don't Like
PPO is an excellent choice for people who want added flexibility when picking their dentists, those who regularly travel, and those who regularly need dental treatments due to long-term dental issues.
Preferred provider organization insurance typically has higher monthly premiums and out-of-pocket expenses, such as deductibles. You generally have to sort out both copay and coinsurance as well.
This is the price you pay for the flexibility provided by PPO, which allows you to use dental specialists both within the PPO network and outside of it without requiring referrals.
The cost of deductibles and coinsurance may differ for services provided by out-of-network and in-network dentists. Without a primary care dentist, some people may find it overwhelming to be more responsible for their own care.
Due to higher monthly premiums, out-of-pocket costs, copayments, and coinsurance, PPO is more expensive than other insurance plans, including a DHMO plan.
A PPO dental plan with no waiting period refers to patients not having to wait for coverage for primary, preventative, or major dental services—and occasionally even orthodontic treatments.
PPO dental plans with no waiting period are ideal for people postponing dental care because of the cost involved or someone who needs to undergo a major dental treatment.
No waiting periods in PPO plans are best for people who need major dental treatments or those putting off dental treatment.
DPPO and dental HMO insurance plans have their key differences and pros and cons, so your decision largely depends on your or your family’s healthcare needs. Here are some critical facts that can help you decide between the two insurance plans:
Generally speaking, a DHMO dental plan might be the right option if lower premiums matter the most to you, you want to save money, and you don’t mind having a primary dental care provider. However, make sure first to review the covered services since some might be limited.
On the other hand, if you want to continue seeing out-of-network dentists, then a PPO could be a better option.
There’s no better option between a DPPO and DHMO plan. When choosing between the two, what matters most is your or your family’s specific healthcare needs.
PPO is quite a common term when it comes to dental health insurance. Here are some of the most commonly asked questions about PPO dental insurance.
Different dental insurance plans come with different kinds of coverage. A key feature of each plan is the ability to access a countrywide network of participating dental specialists. One popular network plan is PPO (participating provider organization).
Before you choose any PPO plan, be sure to find out the specific restrictions of that plan in addition to out-of-pocket costs (such as premiums, deductibles, and copays). Moreover, talk to your primary care dentist to know what type of coverage is accepted in their facility before weighing up different PPO dental plans.
