PPO Dental Plan
Preferred Provider Organization (PPO) dental plans
Brief overview:
Preferred Provider Organization (PPO) is a network of participating dentists that have agreed to accept reduced fees (commonly called the negotiated fee) as payments for patients with PPO dental plans. This is one of the most popular types of insurance plan.
If you have a PPO insurance plan and you visit a PPO dentist, you will only pay a set percentage of the fee. The rest of the negotiated fee is paid to the dentist by the insurance plan.
What you pay:
The percentage you pay (this is called ‘co-insurance’) will vary depending on the type of treatment you are having:
Restorative treatment, such as a filling, may be covered at 80%.
This would mean you only pay 20% of the fee.
Oral Surgery treatment, such as an implant, may be covered at 50%.
This would mean you only pay 50% of the fee.
PPO plans usually require you to pay your part of the fee first (the ‘deductible’) before they pay benefits.
Usually, for preventive treatment, you won’t have to pay the deductible.
Advantages:
This plan typically offers the lowest out-of-pocket costs as long as you visit a dentist or specialist in the PPO network.
You are allowed to visit the dentist of your choice, even if they are not in the network. However, negotiated fees don’t apply to dentists outside the network, so your out-of-pocket costs may be higher.
Dentists in the network have gone through a rigorous credentialing process to be considered for participation.
MetLife negotiates fee schedules with participating dentists to help reduce out-of-pocket expenses.
Be aware that:
PPO plans usually include a maximum amount of coverage per year.
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