Dentist Insurance

It can be extremely difficult understanding the ins and outs of dentist insurance. Confusion commonly arises from understanding the differences between a PPO dentist insurance plan and a HMO dentist insurance plan.

With PPO dentist insurance plans, the companies negotiate fee schedules with dentists in exchange for the dentist being put on a list of preferred providers. Employers then give the list to their employees to match them up with dentists who participated in the dentist insurance plan. dental insurance can help people pay for their various dental treatments, but they won’t cover everything. Most dentist insurance plans have deductibles of $50 to $100. You also have to pay a specified percentage for each type of treatment, and there is an annual maximum amount of funds available for dental care.

Most PPO dentist insurance plans cover preventive care, cleaning, check-ups, protective dental sealants, x-rays, and fluoride treatment at around 80-100%. Base care, like root canal therapy, extractions, and filling, are usually covered up to 80%. Major work such as crowns, permanent bridgework, and full and partial dentures as well as periodontal care are usually covered at 50%.

Many dentist insurance companies have an annual maximum of $1000. Since dentist insurance is not cumulative, if you don’t use it, you lose it. In other words, if you have $150 left over from the previous year, you cannot use it the next year. If not spent, it is not used at all. You start over the next year with $1000 regardless of what you have left unspent the previous year.

HMO’s, on the other hand, are harder to justify for dentist insurance than in the medical community at large. They tend to limit the appropriate care options of patients by physicians. HMO dentist insurance eliminates practices that are not deemed necessary and HMO users are to use only doctors and dentists within the approved network. Also, practice overhead is generally higher in the average dental practice than in the average medical practice and HMO financial compensation is low. 65 to 70 cents of every dollar received at the average dental office is consumed by office overhead, including staff salaries, supplies, lab fees, rent, and more.

While HMO’s offer reduced fees for dentist insurance, it has participating dentists operating at a financial loss. While ethically, dentists will treat all their patients the same, they may have a tendency to rush through with patients who have an HMO. It is not unheard of that an HMO patient will not even receive the complimentary toothbrush and floss at the end of their appointment.

Obviously, the above information makes it seem like that PPO dentist insurance is superior to HMO dentist insurance. However, it really depends on what your needs are. If you are in the position of being able to choose your own dentist insurance, you need to evaluate your needs and that of your family if you have one, what you can afford, and what sort of treatments and care you will need. Only then can you make a proper choice regarding your dentist insurance.