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DPPO, or Dental Preferred Provider Organization, coverage of a patient offers dental services to their clients. The type of insurance held by the patient will determine which dentist they can see for any services they need. We are pleased to accept a number of Preferred Provider Organizations for dental care. Our office can help you get the treatments you need with the help of your insurance provider, as well as the many financial options we have available
Certain insurance companies may allow patients to undergo exams, treatments, and procedures at the dentist office, with copayments or without any payments. If your insurance covers any procedures by a PPO dentist near you, our dental office can help you to file a claim.
It is not necessary to bring your insurance card to our office during your visit. You just need to alert the staff at the front desk about the insurance plan you have, along with any additional information needed. Our office can assist you in determining whether or not your insurance offers coverage for any services offered by our DDS during your visit as well as giving you information about any co-payments which you may be required to pay.
Disclaimer: This information is subject to change on behalf of the insurance company. We are providing this as an informal guide to help you determine which services at our office are covered by your insurance. For more detailed information please visit the insurance’s webpage or contact the customer service or member service number listed on most ID cards.
The logo displayed above is the property of Delta Dental.
Delta Dental supports low-cost dental services as well as giving you options to visit a dentist of your choice. Delta Dental has two different PPO plans for customers which include the Delta Dental PPO as well as the Delta Dental PPO Plus Premier Plan. In Delta Dental PPO dentists have top fee schedules as payments in full and are restricted from billing and recovering fees in excess of the schedule agreed upon. The Premier plan provides certain financial security for enrollees and groups which cannot be observed elsewhere. Members of this plan certainly have an annual maximum coverage which is a predetermined figure of coverage they are allowed to use over a certain period of time which typically is a year. Your annual maximum will depend on the type of coverage you have invested in.
The logo displayed above is the property of MetLife Inc.
MetLife offers the largest network in the nation to ensure disruptions to your plan are eliminated. You still have the option of going outside the network without compromising on the great benefits being offered. Dental fees which are negotiated very between 15 to 45% than the normal charges with the fees perhaps expanding to other services that are not covered.
The logo displayed above is the property of Aetna Inc.
Members have options of choosing the dentist they would like to visit. Members that are using non-participating dentists will receive a reimbursement based on the standard fee negotiated and may have to bear the costs of the balance as billed by the dentist. Patients also have the freedom to visit any licensed dentist without a referral.
The logo displayed above is the property of Anthem BlueCross Inc.
There is a fee of 20% for fillings within the network and the charges are doubled to 40% for using a dentist beyond the network. The deductibles for individuals are both $25 with the enhanced plan costing $150 per family. Dental Blue Basic has an annual maximum of $500 while the annual maximum for Dental Blue Enhanced Plan Is $1250.
The logo displayed above is the property of United Healthcare Inc.
United Healthcare offers different types of PPOs within their services which are identified as Consumer MaxMultiplier, FlexAppeal Preventive MaxMultiplier, And FlexAppeal Enhanced. The first option is designed for patients to come for regular checkups and will incentivize you with extra coverage as a reward. This indicates that members with this plan can obtain treatments such as cleanings, x-rays, fluoride and sealants for children without the fear of having dollars deducted from the annual maximum allotted to them. The sum total annual maximum is set aside for other dental care services like fillings and crowns.
The mainstay of the second option is preventive care because these services will be paid for by taking nothing away from your deductible. Three major benefits are available in the third plan which includes additional cleanings for gum treatments, white fillings for back teeth as well as Dental Implants. Members have the option of choosing from a combination of four adult cleanings or treatments per plan per year.
The logo displayed above is the property of CIGNA Inc.
Three different PPO plans are offered by CIGNA which include the CIGNA Dental Preventive, CIGNA Dental 1000, or the CIGNA Dental 1500. No yearly maximum, no deductible, and all the preventive and diagnostic service charges are included in the CIGNA Dental Preventive. The CIGNA Dental 1000 plan pays $1000 annually by charging a $50 individual or $150 family deductible annually. The CIGNA Dental 1500 is similar to the 1000 plan with the exception that it pays $1500 annually.
Members with this plan who choose to visit an in-network dentist or an out of network dentist will find there are no charges for preventive or routine care after they pay the deductible. For procedures like fillings, extractions, crowns, root canals, surgery, general anesthesia, gum treatment, dental repair, bridgework, and dentures the patient will be required to pay 25 or 50% of the charges depending on the type of services available. The cost of dental services will have to be shared by the patient with this plan.
The logo displayed above is the property of United Concordia.
Preventive services are not included in the deductibles with United Concordia. The deductibles are $100-$300 with an annual maximum of $1000. Qualifying members benefit from 100% coverage for periodontal services. In most other services which are not covered an average discount of approximately 30% is offered.
The logo displayed above is the property of Assurant.
The Secure Choice Individual Plan offered by Assurant has no deductibles, claim forms and no annual maximum. It only has a fixed copayment schedule for plan dentists and plans specialists.
The logo displayed above is the property of Guardian.
The largest benefit in the PPO plan offered by Guardian is an average saving of approximately 30% which reduces the costs of treatments while protecting your health and your teeth simultaneously. You will also have information off of payment ahead of time as you would receive an estimate of the pretreatment costs. The Premier Access Plan has everything which is available in the basic plan with the exception of savings which are higher.
The logo displayed above is the property of Ameritas Inc.
Three different plans are offered by Ameritas including the Value Source, EssentialDental, and SensibleChoice. Value Source offers benefits that are priced reasonably for every individual. EssentialDental provides customers the option of getting good coverage for all basic needs at our dental office. The SensibleChoice considers reimbursement on the dollar amount of your plan member’s expenditure for dental care.
PPO dental plans are the most popular types of plans among individuals and families. This type of dental insurance provides an in-network dentist for you but also gives you the freedom to choose a dentist beyond their network. In order to visit a licensed dentist for any dental procedure members need no referral. You also have the option of switching your dentist at any time without seeking permission from your insurance provider.
There is usually an annual deductible which must be paid before the insurance covers dental services. The insurance only pays a part of the cost while the patient is required to bear the other costs.
You have to pay an annual deductible but the figure will depend on which insurance provider you have chosen for yourself. The annual maximum of a patient will also depend on which dental provider and plan they have subscribed for.
For additional information on your PPO insurance coverage, please call us.
Disclaimer: This information is subject to change on behalf of the insurance company. We are providing this as an informal guide to help you determine which services at our office are covered by your insurance. For more detailed information please visit the insurance’s webpage or contact the customer service or member service number listed on most ID cards.
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Dr. Gadhiya is highly educated and experienced in providing dental care. He provides the dental care you and your family need to reach healthy smiles. Read more about our Team.
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