About PPO Dental Plans
PPO dental plans are dental insurance plans that limit dentists, dental services and treatments to a preferred provider organization. The insurance company provides a list of approved dentists in your area to choose from. Many employers offer employees PPO dental plans because the plans are cheaper. If you don't have a dental plan at work, you can get quotes from insurance agents for individual PPO dental policies.
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Identification
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The insurance company contracts with dentists to form a network of dental treatment providers that agree to give the insurance company a discount. If you have PPO dental insurance, you have to choose among dentists from the approved list for dental treatment, but you don't have to choose a primary dentist.
Function
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Dentists agree to accept lower rates from insurance companies for their services so they can get more patients. Some dentists new to an area need to establish a base of patients. You won't have to pay excessive amounts to your PPO dentists because they have a contract with your insurance company to accept set rates. PPO dentists are paid by the insurance company for each service they perform.
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Benefits
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Many PPO dental plans encourage preventive treatment. You may be able to get your six-month check-ups, cleaning, fluoride treatment and yearly x-rays with very little or no out of pocket costs. Insurance companies are usually glad to pay the cost for maintenance that will prevent the need for more expensive dental treatments. If you do need more treatment, you'll pay a co-pay for fillings, root canals, crowns and extractions.
Considerations
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There's a wide selection of dentists to choose from in a PPO dental plan. You will usually have a deductible and a co-pay based on a set amount negotiated by the insurance company. A maximum amount of money will be available each year for your dental care. If you still need treatment after the maximum amount is spent, you'll have to pay for it yourself or wait until the next year.
Warning
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Some PPO dental plans allow you to see a dentist that's no on the list. This is called an out of network dentist. If you go to an out of network dentist, you will pay higher out of pocket costs. You'll have to file claim forms, and you will need a referral to see a specialist. That can all be avoided by seeing an in network dentist.
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