Individual PPO Dental Plans
Unlike other forms of insurance, dental insurance is far easier to obtain as an individual. Dental insurance usually covers only basic, routine checkups, and thus the exposure to the insurance company is reduced on a per person basis. We’ll examine how you can find individual PPO dental plans, and how you can pick between the good and bad in the article below.
There are three major divisions in dental care:
Preventative services – Preventative services include those that you would expect to receive at any normal visit to the dentists’ office. These services include oral exams, tooth and gum cleanings, x-rays, sealants to fix previously filled teeth, and fluoride treatments. These services are standard, and do not vary greatly from insurance company to insurance company. At most, expect that your PPO will provide one or two annual fluoride treatments, but that other coverage will remain constant.
Basic or secondary services – These services are usually provided by a family dentist, but are often done to repair, not maintain, a healthy mouth. Included in this tier are gum therapy, emergency pain care, root canals, fillings, extractions (this does not include wisdom teeth in all plans) and simple oral surgery. Generally, you can view this tier as services that are more complicated than routine treatment, but are not complicated enough to require a specialist.
Major dental and medical – Major services are those that require the help of a specialist, or which require a large, up-front investment. Major dental includes bridging, braces, crowns, denture repair and time-consuming oral surgery of any type. Coverage for these treatments is usually limited to more expensive PPO plans, and major services may not be covered until the insurance company has provided care for six months or more. This holding period is designed to prevent dental insurance customers from joining a policy only when they need major dental service.
Choosing a PPO
Ideally, start first with PPO dental care networks which currently provide care for your preferred dentist. Your dentist office should be able to provide you with a list of networks they are a member of, or insurance companies with which they are willing to do business. Dentist offices, unlike family practice doctors’ offices, usually work with a number of PPO networks, and are willing to accept new patients and new networks as long as they have the capacity to fit patients into their scheduling.
Secondarily, examine how much coverage you would like annually. In most cases, the premiums you pay annually are based on the annual coverage limit, which can range from $500 to $5,000. At the $500 level, there is sufficient coverage for routine examinations and checkups, but often little else. On the higher end of the annual limit threshold, you can expect to have enough coverage for all dental services you could potentially consume during the period.
Annual coverage limits are worthless without knowing your deductible, however. A PPO plan with a $1,000 annual coverage amount and a $500 deductible for routine care is likely to cost very little because the chance the customer receives greater benefits than what they pay in is also very small.
In most cases, you can expect to pay anywhere from $10 to $50 per month for an individual dental policy, and you should expect that this price is negotiable. Many different trade organizations, unions, and industry groups have contracts in place to provide group members a group dental insurance rate, even if they join as an individual. Commonly, alumni associations at universities will also maintain such an offering, and the group rate is often built into the dental policies the university extends to its faculty. Thus, the costs in these plans are lower than average, and would make an excellent reference point on your search to find the best deal on an individual dental PPO plan.