As Americans make choices about their health insurance, many are considering dental insurance as well. While the Affordable Care Act (ACA) was primarily focused on medical insurance, dental insurance cannot be overlooked. There are several types of dental coverage, including Preferred Provider Organization (PPO) dental insurance.
How Dental PPO Plans Work
PPO dental plans function very similarly to a PPO medical insurance plan. While premiums for a dental PPO may be higher than a different type of plan with similar coverage, the insurance allows for a wider range of choices in dental providers. In addition, you will typically not need to choose a primary dentist to coordinate your care.
Patients using a PPO dental plan will have some cost-sharing, such as deductibles, copayments, or coinsurance. There may be an annual limit on the amount of care provided, although not all plans have a limit.
Your out-of-pocket costs for PPO dental insurance will be lower when visiting in-network providers. Unlike HMO dental insurance plans, PPO dental plans are likely to offer at least some coverage for out-of-network care as well. The copayments, deductible, or coinsurance costs will be higher, however.
Because there is no primary dentist coordinating your care, certain procedures may require preauthorization from the insurance company before the work can be done. If a procedure is not preauthorized, you may have to pay the cost yourself.
Is a PPO Dental Plan Right for You?
Dental PPO plans are best for those who value having a broader choice of dentists, and those who don’t want to go through a primary care dentist to coordinate care. A PPO allows more flexibility of care, although at a higher premium price.
If you are someone who travels often, or who lives in one area of the country during part of the year and somewhere else the rest of the year, a PPO dental plan is likely to be a good choice for you. You will be able to get out-of-network care if needed, and while you will pay higher cost-sharing amounts, you won’t be stuck with the whole bill.
All of this flexibility comes at a higher price, however. While a PPO dental plan will likely have a broader network and flexibility of care, the monthly premium and cost sharing amounts will be higher. If you are looking for lower costs, another type of dental plan may be best. However, for many Americans, PPO dental insurance is a great balance between cost and access to a variety of providers.
To learn more about Preferred Provider Organization (PPO) insurance coverage, read The Pros and Cons of a PPO.