Preferred Dental Plans – Your Guide to Understanding PPO Dental Plans


preferred dental plansPreferred dental insurance plans are sometimes used to refer to preferred provider dental insurance policies or PPOs, which are currently the most demanded dental insurance coverage options these days. PPO plans are offered by health care groups often backed or organized by an insurance company. The company then forms a network of hospitals, clinics, dentists, and consumers to allow them to transact and share in a cycle of benefits.

The PPO serves as the liaison, the middle man in the center of these various transactions. Their role is to set the fees so that the providers get enough compensation from a rate that also offers the consumers good deals in dental care. But since dental insurance is a major investment, you should probably learn as much as you can about it.

The Low Down on Preferred Provider Organization Dental Plans

  • How It Works
  • Costs Involved
  • Recommended PPO Dental Plans

1. How It Works

In a PPO plan, consumers who avail of the plan are allowed to seek dental care from their preferred dental care provider. It doesn’t matter whether the provider is part of the PPO network or not. The only differentiating factor is that if the provider is also part of the network, the benefits are higher than if the provider is not.

Usually, the insurance company can cover as much as 80% of the bill if the dentist is part of the network, leaving the remaining 20% for the insured to pay. If the dentist is not part of the network, in some cases, the payment terms are exactly the opposite: the greater percentage of the cost will fall on the shoulders of the insured, while the insurance company will only pay a small amount.

2. Costs Involved

One of the most important factors that fills up the top of a person’s mind when making a decision about dental insurance is cost. What are the costs involved in this particular dental insurance move?

The biggest financial consideration is the monthly premiums. Since PPO dental plans are insurance plans, they require the payment of monthly premiums. This is one disadvantage in availing of the traditional dental insurance plans; the premiums have to add to the increasing pile of bills the regular individual has to pay each month.

The amount of premiums to be paid are also largely affected by the amount of deductibles you pay. This is a yearly fee paid out of the insured’s own pocket. This is a required fee, meaning that the insurance company will not pay for any dental fees unless the deductibles are accounted for.

Also, all members who are insured by a preferred dental plan needs to pay co-payments at the time they seek dental care. Co-payments are the parts of the total treatment cost that the members have to pay. The rest of the amount will be the co-payment share of the insurance coverage.

3. Recommended PPO Dental Plans

In availing of a PPO dental insurance plan, it is also important that you choose the right insurance provider. This will ensure that you will get the promises that came with what you paid for. It’s all good if you choose a plan provided by trustworthy dental insurance providers such as the Delta Dental PPO or the HumanaDental PPO.

The HumanaDental PPO plan, for one thing, comes from a highly recognized company in the medical insurance world. As a member of the plan, you simply have to present your HumanaDental ID to your dentists when you go get treatment. Dentists will charge you only a portion of the total costs of the procedure, and will then submit a claim for the procedure to have it covered. HumanaDental will then review the said claim and pay the dentist the amount the coverage cost.

Finding Freebies with PPO Dental Plans

Another tip for choosing the most advantageous dental plans: look for 100% coverage, which means you don’t have to pay anything for the dental procedures you ask for. This full coverage is only provided usually for the basic preventive and maintenance procedures such as cleanings, x-rays, oral cancer screening, and so on, and are also available only when you go to in-network dentists. Also, most of them put a limit on how many free coverage you get. For example, Blue Shield Dental PPO plans offer 100% coverage on two teeth cleanings in a year. Despite the limitations, free dental care is still free dental care.