Dental hmo or ppo?!


Question:

Dental hmo or ppo?

So I went to the dentist on Thursday..I have cigna hmo...i pay $18.46 a month...It doesn’t cover crap of what I need to be done...So I called my best friends mom who is a ofc manager for a dental ofc and she said that if I change to ppo she will cover 80-100%..price for ppo a month is $45.40..ex:oral irrigation $79.00..but with ppo...it will be $32.00...
They are doing open enrollment now so I can change it no problem..but I wont be able to change back to hmo til may 2008...HELP!!!!!

Additional Details

2 months ago
Do I have to pay a deductible and if so how do I found out how much it is?


Answers:

Ok first off, an HMO is usually cheaper. Most dental plans are nothing like health plans so be careful. 90% of plans are what they call 100-80-50 plans 100% coverage for preventative, cleanings xrays etc, 80 for basic, fillings.., and 50% major. As in crowns dentures, the big ticket items.

A PPO is a nice alternative because the carrier has made a contracted agreement with the dentist to only charge a certain amount for each service. regardless of what is usually charged. Every plan differs, and your friend may only be speaking for her office. I have worked front office for many Dentists as well as for a dental insurance company, through PacifiCare.

The reason your coverage may be more expensive is that you may be going to a dentist out of network or even have a low based plan. Some plans are 75-30-10. Read your contract information carefully and find out which is the case. On the back of your Dental card there will be an 800# for customer service and they can help you figure out the specifics and also whether or not there are other plans available through your employer, (If that is where you got your insurance through) Without knowing the policy, It is hard to tell, But usually Cigna isnt a problem. If you would like though, and are paying for the insurance out of pocket not through an employer, consider Blue cross.. They have the BEST plans out there and the largest network. All Dentists are contracted to certain amounts within your area and the amount of dentists that accept BC/BS is much larger. You will have to Google for the offices in your state as each state usually has its own BC/BS website. Pacificare is good, but mainly on the west coast right now, though it is expanding.

Before anything, Make SURE your dentist is in your Dental carriers network. That is usually the #1 problem. There is a difference between preferred provider and regular network as well. Prefered usually has lower rates. Good luck hun, and make sure you shop around.




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