“In Network” versus “Out of Network Dental Benefits”

If you read the last blog entry about dental insurance, you should be well versed in how dental insurance and medical insurance differ. Beyond what’s been previously discussed,there are also differences in the issue of “in” versus “out” of network. We all know when it comes to medical insurance, it’s better to see an in network Doctor. Not only does this mean the insurance plan will pay for a greater percent of the cost of your visit, but it also means that the fee for the procedure you’re having is drastically less. We’ve all seen the EOBs (Estimation of Benefits) that arrive in the mail showing the amount “not allowed” by the insurance company. This cuts fees down, sometimes in half, of the non-insured, “cash” fee.

This issue gets a little gray when it comes to dentistry. And, at this point I’m speaking only of PPO insurance plans. When I have a new patient coming in, I often get a print out from their insurance company showing their dental insurance benefits based on categories. The categories will be things like Preventive (x-rays, exams, cleanings), Restorative (fillings), Periodontics (deep cleanings and gum care), etc. What we have found is that by choosing to have your dental treatments taken care of by an “out” of network dentist will result in higher out of pocket fee’s, depending on your plan.  It’s pretty obvious that to save money on medical healthcare you need to see an in-network provider

All that being said, there are some “not the norm”  insurance plans out there and you have to know your individual one in order to reap the most benefit from it. There are some plans out there that don’t have very many providers listed with them. This can seem frustrating as the consumer, but believe me, it’s also frustrating for the dentist. We have seen plans that will not allow you to see anyone but who they (the insurance) company tells you to see. These plans are knows as DMO and HMO plans and what we have found is the quality of care that you receive at these establishments are not the kind of dentistry that will last you a long time.

We pride ourselves on delivering quality dental care to our patients while also being able to help save them a little money by offering “in” network dental fee’s. It would be an honor to work with you to meet your dental goals. Please email us at info@PrestonOneDentalStudio.com or call our office at 214-431-4998 to schedule an appointment.


Next post will be about Discount plans like Priority Dental Plan.

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