Understanding insurance plans can be difficult. If you are employed and receive dental coverage from your employer that is great.  Dental managed care plans are often either a PPO or HMO. Standing for preferred provider organization and health maintenance organization.

  • PPO insurance plans allow patients to see any dentist of their choosing or within the network
  • HMO insurance require only seeing a dentist that is part of that HMO plan

As a subscriber of a PPO you can go to your favorite dentist even if the dentist is not part of that insurance network.   This means you will pay a little more, but a least the insurance pays for the treatment.  Dental insurance can help pay for dental treatment but it has its limitations too.

Most insurance plans have a deductible of $50 to $100 you’ll pay once when you start treatment for the plan year.  Pay only  a percentage for each type of treatment, some not at all.  Also have a yearly max amount available for your dental care.  Read the plan carefully and choose the max appropriately.  If you are someone with a history of dental problems and your dental health is not stable, a higher maximum would be better.

Most PPO plans cover preventive care, cleanings, check-ups, x-rays, sealants and fluoride treatment 80-100%. Basic care including root canal therapy, extractions, and fillings are usually covered at 80%. Major dental treatment such as crowns, bridges partials and dentures often fall under 50% coverage. most insurance offer a yearly max of $1,000. Dental insurances coverage does not roll over. If you don’t use it, you lose it.  Here at Partners In Dental Health we are in network with these PPO’s.

and soon more.

Feel free to discuss your insurance plan and financial questions with our Insurance Coordinator prior to dental treatment.