Dental Insurance and PPO Networks - You may have arrived on this page because your dental office said they accept PPO plans. PPO (Preferred Provider Organization) networks consist of a network of dentists that are contracted to provide dental care at a lower cost instead of their usual cost. This will save you money on dental procedures and the plan will also cost less. In network providers will bill the insurance company directly. PPO plans also allow you to use dentists that are outside of the network. This gives you a good balance of savings and the freedom to keep your own dentist. The plans below are Not available in MA, NJ, NY or VT
Spirit Dental Insurance No Waiting Period Dental Coverage
- No Waiting Periods for Preventative, Basic or Major Services - Includes Implant Coverage
- Plan Option - Network - (Ameritas Classic PPO Network). Procedure fees can be 30% below the average for your area. The Network option will also pay the same amount when going outside of the network
- Plan Option - Choice - Use any dentist (Pays based on Usual and Customary) or use an Ameritas Classic PPO Network provider for greater savings and lower out of pocket expenses
- Annual Plan Maximums of $1200, $3500 or Increasing maximum to $5000 per Person
- Includes three free cleanings and two exams per calendar year (January thru December)
- Major Services Paid 50% in CT and IL Starting Day One. All other states are paid up to 25% Year One and 50% Year Two which begins on January 1st 2019
- $100 Lifetime Deductible - Once your deductible is satisfied, you no longer have one.
- Optional vision insurance for $7 Applicant, $14 Applicant plus one, $20 Family
- Includes Orthodontic (braces) coverage for children under 19 years of age
- Plans available in all states EXCEPT: MD, MA, NJ, NY, VT, WA
Independence Dental Insurance by the IHC Group
- PPO Dental Insurance and Indemnity Plan Options - Plan can become effective as Early as Tomorrow
- No Waiting periods for exams, cleanings or diagnostic x-rays. 6 month waiting period for basic procedures and 12 months for major procedures
- Plan Option - PPO uses the DenteMax PPO Network. Lower out of pocket expenses when using a network provider. Pays the same amount when going outside of the network. The PPO network available may vary by state
- Plan Option - Indemnity - Plan name: Independence 1000, 1500 and Ultra 1500. Use any dentist (Pays based on Usual and Customary)
- $50 Calendar year deductible. Deductible does not apply to preventative or diagnostic x-rays with the 1000 or Ultra 1500 options
- Affordable PPO and Indemnity plan options with calendar year maximums up to $1,500 per person
- Underwritten by Independence American Insurance Company Rated A - Excellent
- Plans available in all states EXCEPT: MA, NJ, NY, VT
Independence Dental PPO and Indemnity Network Information
When utilizing in-network dental providers with the PPO plan: Network providers have agreed to a negotiated, discounted dollar amount for each covered charge. Therefore, if all dental services are received from network providers, you will not be billed for any charges above the allowed amount, or maximum allowable charge.
When utilizing out-of-network providers: If you receive dental services from a provider that is not included in the network, covered expenses are limited to the maximum allowable charge.* You will receive a bill from the provider if out-of-network expenses exceed the maximum allowable charge.
Indemnity Plan (Independence 1000,1500 and Ultra 1500): Charges in excess of the Usual, Customary and Reasonable charge are the responsibility of the insured person. This amount is the most common charge for treatment and services within your geographic area and is determined by the insurance carrier based on claims data and a standard allowance level.
The PPO network available with Independence Dental varies by state. Please refer to the provider directory (when running a quote) for a complete list of available network dental providers in your area.
*Not available in all states.
Spirit Dental PPO Network and Choice Information
In addition to paying lower monthly premiums, the Spirit Network plan can help reduce your out-of-pocket costs. Network providers have contracted fees (MAC/maximum allowable charge) for each service rendered as the basis for payment under the Spirit Dental Plan. This amount is typically significantly less than the amount which could be charged by an out-of-network dentist. These network dentists are prohibited (by contract with the network) from charging you the difference between their typical fee and the amount negotiated with the network. Dentists not participating in the network are not subject to the negotiated amounts and are permitted to charge any fee for services they provide. This may lead to greater out-of-pocket costs for you and your family members. The sample comparison chart below will give you an idea of how you can save money by selecting one of Spirit Dental’s network plans and visiting an in-network provider for services. It compares the charges between visiting in-network and out-of network dentists.
What is the difference between a Dental Insurance plans and a Dental Discount plan?
Dental Discount or Savings plans provides network discounts on most procedures when using a dentist in the plan network. These are the same network discounts that many dental insurance plans use. Dental Savings plans also have no waiting, so you can use a savings or discount plan immediately for preventative, basic and major services. With this type of plan, you have to stay inside the plan network.
Dental insurance pays a percentage of the cost of your procedures, this is where the insurance company comes in. The payment amount is based on the usual and customary dollar amount for your area (the normal charge for a procedure by dentists in your area or zip code). Preventative services have no waiting periods but, most Dental Insurance plans will have a waiting period for basic and major services or they pay a lesser amount the first year that you have the plan. Unlike dental discount plans, insured plans also have deductibles. If you need help deciding, which type of dental coverage is best for you, simply give us a call.