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Wednesday, September 11, 2013

PPO Dental Insurance at a Glance

Most health insurance plans in the U.S. are either managed by a healthcare maintenance organization (HMO) or a preferred provider organization (PPO). Many healthcare practitioners prefer PPO over HMO due to its suitability in terms of coverage. As you know, dental insurance works differently from other types of insurance since most, if not all, of the dental problems can be prevented and treated with less cost. In exchange for PPO insurance, however, the dentist now becomes a “preferred provider.”

Consumers still have the choice of whether or not to go to a preferred provider, but the cost will be higher in a non-preferred provider. PPOs are also simple; unlike HMOs, PPOs don't need any referrals, let alone a primary care provider, for the plan to take effect. This translates to more patients for a dentist as he can treat patients regardless of referrals. With HMOs, however, patients need proof of referral before the dentist can treat them.

In PPOs, preventive dental care coverage ranges between 80 and 100 percent, basic care at around 80 percent, and major dental work (e.g. implants, crowns) at 50 percent. For a regular check-up worth $50, the patient may only need to pay no more than $10. The rest of the cost is shouldered by the PPO. It's safe to say that patients who regularly practice proper oral hygiene get to pay less for dental care.

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