We Accept Most Dental PPOs. please call us and we can discuss your coverage over the phone.
A DPPO or also known as Dental Preferred Provider Organization provides dental insurance services to its members. Normally, the type of DPPO a patient has will decide which dentist they can go to for all their dental needs. Our office accepts several types of PPOs and are glad to provide assistance with your dental insurance.
As mentioned, there are several types, all which allow patients to receive treatments, exams as well as certain procedures; some with co-payments or no cost. We will be more than happy to help you file any needed claim.
When you come to our office for your first visit, all you need to do is mention the type of insurance plan that you have to our front desk and answer any additional questions if needed. Our office will help you understand if your insurance will cover the procedure that you want and if a co payment will be needed.
Below is NOT a complete list. Please call our office.
Delta Dental allows its members to get low cost dental services together with their dentist of choice. In this insurance, there are actually 2 types of PPO plans that are available, which are the Delta Dental PPO plus Premier plan and the Delta Dental PPO.
Plan members have the annual maximum coverage that is a set and specific amount of coverage that the members can use in a time period, typically a year. Now, while all members can enjoy the annual maximum coverage, the actual amount will be dependent each member’s coverage. Other differences in billing and collecting fees vary by plan, however the Premier plan adds additional financial security that is unmatched elsewhere.
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Metlife is another insurance that our office accepts. This type of insurance has one of the largest networks which ensures lesser plan disruption. With this type of insurance, members dental fees can range from 15% to 45% lower compared to the average dental charges in the market.
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Unlike the other insurance, Aetna covers preventive care which typically includes cleanings, x-rays, check ups etc. With a wider coverage, Aetna also covers a few more services such as crown fillings and root canals. With this insurance plan, the members can choose between going for a self funded plan or an insured option. Aside from this, members can also choose from a list of maximum benefit levels.
What’s good with Aetna is that the member can still go to a non-participating dentist and the cost of doing so may be reimbursed. Aside from being able to choose their dentist and choosing their benefit levels, Aetna members can also visit any licensed dentists without the need for a referral from your previous dentist.
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Cigna has three plans: the Cigna Dental 1000, Cigna Dental Preventative and the Cigna Dental 1500.
Cigna Dental Preventative has no yearly maximum and no deductible, with the diagnostics services and preventative services charged. Cigna Dental 1000 and Cigna Dental 1500 are almost alike; the only difference is the amount that the plan pays $1000 or $1500 annually.
Also for the Cigna Dental 1000 and 1500, both plans covers the routine and preventive care after the deductible. In addition, with either of these two plans, the member pays either 25% or 50% (depending on the service) for the following procedures, root canals, extractions, gum treatment, dental repair, crowns, bridgework, fillings, dentures, general anesthesia and surgery.
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There are two types of plans under Blue Cross insurance. One is the Dental Blue Enhanced plan while the other is the Dental Blue Basic plan. What’s nice with Blue Cross is that in both plans, preventive services are all covered within the network and if you choose outside the network, then it will still cover 80% of it. With the basic plan, you will just need to wait for 6 months, while with the Dental Blue Enhanced plan, then your waiting period for major services will be 12 months.
When it comes to the annual maximum of these two plans, Dental Blue Basic is at $500000 while for Dental Blue Enhanced, it is at $1250000, both with 20% fee for fillings done within the network and 40% outside the network.
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United Healthcare has three plans that a member can be a part of such as the FlexAppeal Preventive MaxMultiplier, Consumer MaxMultiplier and the FlexAppeal Enhanced. One main difference of the the three is with the Consumer MaxMultiplier. In this type, members are encouraged to have regular check ups and in doing so, an extra coverage is rewarded to them. This means that members of this plan can actually get procedures done such as X-rays and cleanings plus additional without actually having the cost deducted from the annual maximum, which is then available for other dental care services.
With FlexAppeal Preventive MaxMultiplier, preventive care will be paid and only dental services will be billed to the members deductible. FlexAppeal Enhanced on the other hand provides three main benefits such as additional dental implants, cleanings for gum treatments and white fillings for back teeth.
To top it off with these plans, the member has the option to choose from either four adult cleanings or four gum treatments per year.
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Preventive services are not included in the deductible, which are $100/300 with a $1,000 yearly maximum. The average discount that a member can get for most non-covered services is up to 30%. Qualifying members, however, receive 100% coverage for different periodontal services.
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If you have the Secure Choice Individual Plan, there are no deductibles and no annual maximum and no claim forms. Instead, members will have a fixed co-payment schedule for Plan Specialists and Plan Dentists.
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Guardian’s PPO plan boasts an average savings of 30% on treatments, and advance notice of what your payment is expected to be in the form of a pre-treatment cost estimate. The Premier Access plan, members enjoy the benefits of the basic plan with greater savings.
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With Ameritas, members can choose from one of the three plans that they offer. Value Source wherein benefits are reasonably priced for the members and are quite competitive, EssentialDental, wherein members are able to get good coverage for all their basic dental needs and the SensibleChoice plan which has the ability to reimburse the dollar amount of a member’s dental care expenses.
The above logo is property of Ameritas, Inc.
Among the different insurance plans, PPO Dental Insurance is known to be the most sought after by individuals and families because it provides dental insurance within and outside the network. Aside from this, members are allowed to switch dentists at any point of the membership and there is no need for a referral to do this.
With PPO Dental insurance, the dental provider covers part of the cost and the remaining cost will be covered by the member; however like many other insurance options, an annual deductible will need to be met prior to insurance covering dental services. This annual deductible and annual maximum will depend on the members plan and provider.
For more information on your PPO insurance coverage with us, call or visit our OC dentist in Costa Mesa, CA today. We are located just minutes from Newport Beach and close to Irvine, in beautiful Orange County.
Disclaimer: This information is subject to change on by each individual insurance company. We are providing this as an informal guide to help you determine which services at our office may be covered by your insurance. For more detailed information please visit your insurance’s webpage or contact the customer service or member service number listed on most ID cards.