Dental Insurance Articles
Two Costs Associated With Using Dental Services That Lie Outside The Provider Network
2010-05-18
When choosing dental insurance coverage, there are typically two main plans that a consumer can decide between, similar to health insurance plans. You can opt for an HMO or a PPO provider. Each of these has its benefits and drawbacks, and ultimately it comes down to an individual's preference and dental needs. The choice will also depend greatly upon an individual's financial situation, and ultimately, dental care decisions are usually made according to cost.
With an HMO, premiums and co-payments are usually lower and there are no deductibles, meaning that any out of pocket expenses that you pay will be lower as well. However, in order to receive these benefits, you are usually limited in the care you can receive, and where you can go to get it. You must choose a dentist from a pre-approved list within a network. If you opt to seek treatment or outside of network services, you may find yourself paying for the full amount as an HMO will not cover these expenses. A PPO is a little more flexible, but also more expensive. You will have to pay deductibles as well as higher premiums. A PPO will allow you to pick your own dentists. They do recommend that you use a provider in the network, as you will be charged less this way. If you do use out of network services, you pay a higher rate.
If you do choose to seek dental services outside of the approved network, you need to be prepared to pay higher bills out of pocket and you need to be aware that insurance companies may not even cover certain services and treatments. Because many major treatments or oral surgeries must be pre-approved before they are covered, you may find yourself paying for treatments such as root canals, bridges, and difficult tooth extractions. As well, you may be responsible for the cost of dentures and denture repairs. These can run you a bill of several thousands of dollars. When you decide to go to a dentist that is not a member of the network your insurance company uses, you will have to either complete all paperwork on your own or you will be charged by the dental office for this service.
When you obtain a dental insurance quote, be sure to inquire about the difference between using in network and outside of network services. Each plan can vary even slightly and it is important to know exactly what you are covered for so that you do not receive any surprises when you are billed. You should really consider staying within the network in order to save yourself money on dental insurance quotes as well as receiving more comprehensive services with less hassle.