Ah! The joys of health and dental insurance. Without exception, it’s probably fair to say that most people in Aledo and everywhere are intimidated by it: as we buy it, it sounds great and we feel protected. But oftentimes, after we’ve had to use it for one reason or another, invariably we wonder why our insurance didn’t pay for more. We get it—we’re patients, too! So we’re going to take a brief look at insurance and do our best to explain it to you here.shannon
The most common types of dental insurance are DMOs (or dental maintenance organization—the dental version of HMOs) and PPOs (preferred provider organization). Chances are that you have one of these if you have dental insurance.
To briefly explain the difference, PPOs negotiate set fee schedules with dentists in exchange for the dentist being listed as a preferred provider. These plans usually have a deductible to be payed by you, and pays a pre-planned percentage of each treatment or procedure. And oh—there tends to be a yearly maximum of benefits paid out for dental care. The good news is that PPO plans usually pay for preventative care (cleaning, check-ups, x-rays, etc.) at about 80-100%. Root canals, extractions and fillings are paid up to 80%, and the major stuff, like crowns, permanent bridgework and dentures are only paid at 50%. So, all in all, it’s not too bad since chances are the routine stuff is basically paid for with minimal out-of-pocket expenses. The other upside is that you get to choose your own dentist.
DMOs, on the other hand, require that you use dentists in their “network”. So even if you already have a dentist you’ve been using, and you enroll in a DMO plan that does not include your dentist… well, you’re out of luck. They won’t pay for any dental services if you continue to use your dentist. The upside is that you generally pay considerably less out-of-pocket overall for each treatment or procedure overall.
Here at 1187 Dental of Aledo, we accept most PPO dental insurance plans; we currently are not in any HMO network at this time. Regardless of whether you have dental insurance or not, your dental health is really important to us. If you are in the Aledo area and want to a dentist that truly cares about his patients, give us a call!