Making regular dental trips shouldn’t be a difficult task. However, if you’re unsure on how exactly your insured or don’t have a plan in place for when to use your insurance, you’ll want to keep reading. Your dentist in Cumming wants to make sure you stay informed.
Whether you need to clarify the difference between an HMO and a PPO or figure out a plan for getting your restorative work done, your dentist has the answers.
The Difference Between Dental Plans: PPO vs. HMO
If you’re using a dental PPO (Preferred Provider Organization) plan, you’ll find a balance between lower costs and dentist choice. Dentists who are in a PPO are in a network. This means they have agreed to contracted fees as payment in full rather than the usual fee they charge patients with a PPO insurance plan. When you visit your PPO dentist, you’ll pay a reduced rate known as coinsurance, while your insurance plan pays the difference. You’ll find it easier to choose a dentist you want with this plan.
HMOs (Health Maintenance Organization) on the other hand, are quite different. In this case, you choose one dentist or dental practice to handle all your oral health needs. HMOs, also known as pre-paid plans, do no have any deductibles or annual maximum amounts of coverage. In this case, you pay the dentist a fixed amount called a copayment or copay for short. While preventive services are widely covered under this plan, using a dentist out-of-network could make you responsible for the entire bill.
Getting Your Restorative Work Done Early
If you plan to receive extensive restorative work in the future, you’ll want to discuss this with your dentist prior to setting your dates. To avoid paying additional out-of-pocket costs, try to plan your dental work around the insurance you have rather than setting a random date for each of the treatments.
For example, say need 2 crowns and 2 filling completed. If you start at the beginning of the year, you’ll have your maximum amount of benefits available to you and plenty of time to get them completed. If you find yourself towards the end of the year, try to schedule half your appointments after the 1st of January, as this is when most dental plans reset.
Making Regular Checkups a Habit
Dental insurance is big on preventive care, which is why they like to cover a majority of the treatment. It shows you are going out of your way to avoid gum disease and prevent tooth decay, two conditions that would only cost your insurance company more.
To get the most out of your benefits, shoot for 2 checkups and 2 cleanings a year. Your dentist will be able to perform deep cleaning as needed to prevent tooth decay and catch any underlying diseases and treat them early, saving you time and money that could be spent elsewhere.
Keep your benefits in mind. Schedule an appointment with your dentist in Cumming today to build a treatment plan!