Dental insurance can help you save on dental care, but it works a lot differently than the medical insurance that you understand now. Because of this, dental insurance can be difficult to navigate. One factor that can contribute to your benefits is whether you opt for an in-network or out-of-network dentist. Continue reading to learn more about dental insurance plans and how they work. The year will be over before you know it, so now’s the time to make the most of your benefits!
Which Dental Insurance Plans Are Available?
There are two main types of dental insurance:
- Health Managed Organization (HMO): This type of plan offers dental coverage for monthly or yearly fees. However, they limit the providers that you can go to. This means that you will be given a select list of dentists in-network in your area to choose from. If you go to a dentist who is not on the list, it will not be covered by your dental insurance. Instead, you will be left responsible for the entire bill.
- Preferred Provider Organization (PPO): With a PPO dental insurance plan, you will also receive dental care at reduced rates. However, you can choose any dentist you’d like. If you choose an in-network dentist, you will receive treatment at pre-established rates. You can still go to an out-of-practice dentist, but a customary fee schedule will be established. You or the dental office will file a claim so you can be reimbursed.
How Does an In-Network Dentist Work?
When you choose an in-network dentist for your oral health needs, you will usually pay less at the time of your service. In most cases, plans cover 100% of preventive care, 80% of basic procedures, and 50% of major procedures. You don’t have as much freedom when it comes to picking your dentist, but you will be looking at lower out-of-pocket expenses.
How Does an Out-of-Network Dentist Work?
For PPO plans, your coverage from different treatments can range anywhere from 100% to 50% to 40% depending on your plan. Out-of-network dentists aren’t contracted with your insurance company, so there are no pre-established rates. Fortunately, you can still file claims and have money reimbursed. It is up to you to decide if seeing an out-of-network dentist is the best option for you.
Now that the end of the year is approaching, there is no better time to take advantage of your dental insurance benefits. Beginning in January of 2024, all of your unused benefits will go to waste, and you will be left responsible for your annual deductible again. If you have unused benefits, now is the time to schedule your next visit!
About the Practice
At Baldwin Family Dental, we have a team of three experienced dentists eager to serve patients in Panama City. With their combined skills and expertise, patients can get pretty much anything they need in one convenient location. We are in-network with numerous popular dental insurance companies. To learn more about dental insurance or to schedule an appointment visit us before the year ends, visit our website or call (850) 215-0128.