When it comes to dental plans, many people are confused. It can be challenging at best to find the right insurance coverage to fit a budget. However it must be done, oral health can greatly affect your overall health.
The terms PPO and indemnity are very confusing when you're shopping for the right dental insurance. It's important to know the difference.
Your out of pocked expenses will vary with the plan that you select. You'll also be paying a specific premium and you'll want to stay within your budget.
PPO stands for Preferred Provider Organization. This encompasses a network of providers who give dental health services at a discounted cost to the consumer. This discounted cost is part of the agreement that the Preferred Provider Organization has with the insurance companies and in a few cases with the specific group that they are affiliated with.
If a person has a PPO plan they are still able to select a provider that isn't in the network, but these will be more expensive to the consumer. PPO consumers will have a pre set monthly rate that they pay and their dental insurance will cover the basics such as exams and other services.
There will also be a deductible that the consumer is responsible to pay to the service provider. The dentist will submit the bill to the insurance company and the patient will pay what isn't covered.
An indemnity plan on the other hand, gives consumers the ability to seek services from any dental care provider. They have no network provisions and the consumer will be reimbursed for set amounts of the fees no matter who they seek out as a dental care provider.
The consumer who has an indemnity plan can receive a dental cleaning and the indemnity plan will pay a flat rate for said service. If the cost is above the set flat rate the consumer must pay that amount to the dental care provider.
Each indemnity plan is slightly different so it's vital to read the fine print and know what the plan will and will not cover. If you have fairly good teeth you may only need a few fillings now and again and a good cleaning. On the other hand, if you have poor teeth or poor oral health you may require more comprehensive services. The more comprehensive the services the more costly the plan will be.
While an indemnity plan may be more expensive, it may also allow for more flexibility. If you're living in a rural area for example you may not have any PPOs available.
It can be challenging at best to determine which dental services will best suit your specific needs. You'll have to take into account your location (rural or city), budget, dental care needs and more.
Once you understand the differences between PPO and indemnity plans you can then move forward and select the plan that will best suit your specific needs. Choosing a dental plan can be a daunting task but with the right information you'll be able to select the best plan for you and your family.