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Delta Dental PPO

You can choose from many different kinds of dental plans, but Preferred Provider Organizations (PPO) are far the most popular. In fact, more than 80% of dental insurance plans are PPOs.1

So why have PPO plans emerged as the popular and smart choice? Because PPO plans offer clear advantages as suggested below.

 A PPO plan can save you more money.

Insurance companies develop a network of dentists who agree to charge you fees that are lower than their usual rates. Those discounts are the deepest when you visit a PPO network dentist.

 You have options and flexibility.

A PPO plan will offer you a variety of choices from a network of dentists. You also have the flexibility to visit any licensed dentist – even out-of-network dentists— but you can maximize your savings and benefits visiting a PPO network dentist who has agreed to lower fees. In other words, your out-of-pocket expense is much less. 

 Source: https://www.deltadental.com/us/en/protect-my-smile/dental-benefits/dental-insurance/ppo-dental-insurance-plan-benefits.html

Delta Dental PPO Plan

You can visit any licensed dentist, anywhere, or keep the dentist you know and trust. Save the most visiting a dentist from our PPO network. These dentists agree to reduced fees, and won’t charge you more than your expected share of the bill. They also complete your claim forms and help you understand your share of the payment.

Source: https://www1.deltadentalins.com/individuals/plans/delta-dental-ppo.html

What Does Delta Dental PPO Cover

Generally, dental policies cover some portion of the cost of preventive care, fillings, crowns, root canals, and oral surgery, such as tooth extractions. They might also cover orthodontics, periodontics (the structures that support and surround the tooth), and prosthodontics, such as dentures and bridges. You’re usually covered for two preventive visits per year.

If you get an individual policy, periodontics and prosthodontics may not be available in the first year of coverage. And orthodontics often requires a rider, in which you pay an additional fee, for any kind of policy.

Most plans follow the 100-80-50 coverage structure. That means they cover preventive care at 100%, basic procedures at 80%, and major procedures at 50% or a larger co-payment. But a dental plan may elect not to cover some procedures, such as sealants, at all.

Every plan has a cap on what it will pay during a plan year, and for many that cap is quite low. This is the annual maximum. You pay all expenses that go beyond that amount. About half of dental PPOs offer annual maximums of less than $1,500. If that’s your plan, you’d be responsible for all expenses above $1,500. If you need a crown, a root canal, or oral surgery, you can reach the maximum quickly.

There’s generally a separate lifetime maximum for orthodontics costs.

Complete Article: <https://www.webmd.com/health-insurance/dental-insurance-overview

Most all companies including Delta offer a variety of plans and coverage based premium we can help determine at Woody’s Insurance what may be the most beneficial plan for you.

Delta Dental PPO Plus Premier Coverage

With this plan, members enjoy outstanding access and considerable savings leveraging two of our national dental networks: Delta Dental PPO and Delta Dental Premier, the largest dental network in the country. This program features two levels of claims savings.

 For the greatest flexibility, members can choose a dentist in our Premier network, which includes three out of four dentists in the country and 96% of dentists in Massachusetts.

 For the greatest value, members can choose a dentist in our PPO network, which includes 20% of Massachusetts dentists.

  • Coverage for diagnostic and preventive care, including routine checkups, restorative care, and oral surgery
  • No claims forms to fill out when services are performed a participating dentist
  • No balance billing participating dentists
  • Coverage for services performed non-participating dentists at a lower benefit level
  • Savings generated through our negotiated fees, our claims processing, and our utilization management program
  • Special plans for smaller businesses (10-49 employees)
  • Rollover Max, which allows a portion of a member’s unused annual maximum to be carried over to the next year, for greater value. Limitations apply, and some programs exclude this feature. Please refer to your benefit materials or contact customer service for more information.

Original Article: https://deltadentalma.com/dental-plans/delta-dental-ppo-plus-premier/

Delta Dental PPO Orthodontics

Proper tooth alignment is important not only for a beautiful smile but also for function. When teeth are aligned, it’s easier to chew and talk. And it’s also important to correct and guide tooth and jaw development as a child grows, in order to ensure a healthy and functioning smile for adulthood. Orthodontic services often referred to as “ortho”, are services, treatment, and procedures used to correct malposed or misaligned teeth. These services can include braces, retainers, and other orthodontic appliances. Your coverage level for orthodontic services depends on the plan chosen your employer/organization. Orthodontic services are a Class IV benefit, usually payable for eligible people up to age 19, and limited to the lifetime maximum per person as specified in your Summary of Dental Plan Benefits.

Source: https://www.columbus.gov/uploadedfiles/Human_Resources/Healthy_Columbus/Health_Resources/How%20we%20pay%20ortho%20sheet(1).pdf

Delta Dental PPO Cost

Delta Dental plan premiums vary state and plan. According to its website, the plans rank from least to most expensive as follows:

  • DeltaCare USA (HMO)
  • Delta Dental Patient Direct
  • Delta Dental PPO
  • Delta Dental Premier
  • Delta Dental PPO Plus Premier4

Below is an example of sample quotes for two adults aged 35 and 34 with two children residing in Chicago.5

  Gold Plan Silver Plan Bronze Plan
Office Visit Co-payment None None None
Plan Dollar Maximum Per Person, Per Year $1,500 $1,000 $500
Deductible $50 per person, per benefit year for all services $75 per person, per benefit year for all services $25 per person, per benefit year for all services
Annual Contract Required Yes Yes Yes
Waiting Periods May apply May apply None
Cost Per Month $125.46 $105.27 $61.93

Complete article at: https://www.thebalance.com/delta-dental-insurance-company-review-4147686

DPO Vs PPO Dental Plan

A dental plan organization (DPO) organizes services with a network of doctors. In exchange for a premium paid to the DPO, a member of the DPO can use any of the DPO’s network doctors at a reduced fee. This fee, often called a copay, is the only cost for the services administered in most cases. The DPO will pay all other costs at a reduced group rate.

DPO Benefits

A DPO offers patients a network of doctors who will administer services at a heavily reduced cost. Many dentists will not accept patients without some form of insurance, because they fear the patient will not pay a bill in full on his or her own. Dentists are not as concerned as doctors with these issues. However, it is still easier to get quality medical care if you are a member of an insurance plan.

DPO Pitfalls

Once a patient is a member of a particular DPO, that patient will not receive the same benefits if they go “out of network” to another dentist. This can create restrictions on services. Further, the premiums paid to a DPO are only worth the cost if the patient makes use of the services.

Verses a PPO Dental Plan

PPO Plans

A PPO plan is regular indemnity insurance combined with a network of dentists under contract to the insurance company to deliver specified services for set fees and according to the provisions of the contract.

Contracted dentists must usually accept the maximum allowable fee as dictated the plan, but non-contracted dentists may have fees either higher or lower than the plan allowance.

source: https://success.ada.org/en/dental-benefits/dental-plan-overview

At Woody’s insurance, we can further discuss DPO vs PPO insurance. 

DPO Insurance

A Dental Plan Organization (DPO) is any person or company who provides directly or arranges to administer one or more plans providing dental services that are on a prepaid or postpaid individual or group capitation basis. The covered person is eligible to receive treatment from in-network dentists only (except in the case of an emergency over fifty (50) miles from home). The covered person may be required to pay a deductible or copayment for treatment, but no balance billing is allowed.

Original:https://www.thebalance.com/delta-dental-insurance-company-review-4147686

Want to know more DPO Insurance contact us at Woody’s Insurance.

DPO Dental Plan

Designated Provider Organization (DPO) plans are primarily offered to hospital employer groups (and their families) to encourage them to seek services from providers within that same hospital group, in exchange for lower or waived copays. The DPO plan is available as a Preferred Provider Organization (PPO) or Point of Service (POS) and is typically self-insured.

 Complete article: https://tuftshealthplan.com/documents/providers/general/dpo

PPO Insurance Plans

A type of health plan that contracts with medical providers, such as hospitals and doctors, to create a network of participating providers. You pay less if you use providers that belong to the plan’s network. You can use doctors, hospitals, and providers outside of the network for an additional cost.

PPO Insurance Cost 

A preferred provider organization, or PPO, is a health or dental insurance plan that contracts with hospitals and doctors to create a network of coverage. Typically, in a PPO health plan, you will pay less if you use providers within the network. However, you can still go to out-of-network doctors but can expect to pay an additional cost for coverage.

Original article: https://www.valuepenguin.com/ppo-health-insurance-plans

Because of the flexibility of PPO insurance, it generally costs more than many of the other types of insurance such as HMOs….Woody’s Insurance can help you determine if the additional cost is the best for your situation.

Best Dental insurance For Major Dental Work

The Major dental services category typically includes procedures and treatments that are relatively more complex in nature and often involve a dental laboratory expense. These services tend to be more costly than those found in the Basic category.

Benefits level

With indemnity and PPO insurance policies, the benefits provided for Major dental services frequently run on the order of 50% of the procedure’s cost, after the deductible has been met. With HMO plans a copayment is typically required.

 List of Major dental services.

dental crowns (maybe a Basic service) – (Details about insurance coverage for dental crowns.)

inlays and Onlays

bridgework

tooth implants

impacted wisdom teeth removal (maybe Basic)

complex oral surgery procedures

anesthesia/sedation

removable partial dentures

complete dentures

denture relines and rebases

denture repair

orthodontic treatment

For help with the best dental insurance for major dental work contact Woody’s Insurance.

For the complete article go to https://www.animated-teeth.com/dental_insurance/a-dental-insurance-plans-major.htm

Full Coverage Dental Plans

Generally, full dental policies cover some portion of the cost of preventive care, fillings, crowns, root canals, and oral surgery, such as tooth extractions. They might also cover orthodontics, periodontics (the structures that support and surround the tooth), and prosthodontics, such as dentures and bridges. You’re usually covered for two preventive visits per year.

If you get an individual policy, periodontics and prosthodontics may not be available in the first year of coverage. And orthodontics often requires a rider, in which you pay an additional fee, for any kind of policy. 

Source: https://www.webmd.com/health-insurance/dental-insurance-overview

To find out more about full coverage dental plans contact Woody’s Insurance.

Best Dental insurance For Seniors

Millions of financially vulnerable seniors and adults with disabilities qualify for—but are not yet enrolled in—benefits that could help them pay for prescription drugs, medical care, food, or heat for their homes.

Understand the ins and outs of Medicare & Medicaid, including enrollment options and programs to save seniors money.

Medicare prescription drug plans and related benefits programs can help older adults pay for certain out-of-pocket costs with their medications.

NCOA connects low-income seniors to several benefits that fight hunger and promote nutrition.

Several public and private benefits programs can help pay home energy costs, vision, dental, hearing, and more.

Source: https://www.ncoa.org/economic-security/benefits/

To find out more about the best dental insurance for seniors contact Woody’s Insurance.

Dental insurance No Waiting Period For Major Services

A dental insurance waiting period is the length of time after purchasing your dental benefits plan that you must wait before you can use your full coverage.

During the dental plan waiting period, the dental insurance company will not pay for certain procedures. A dental benefits waiting period may last anywhere from a few months to a full year, depending on the type of plan you have purchased and the insurance benefits wording.

The details of what is covered in the plan immediately versus what coverages are subject to a waiting period will be clearly outlined in your plan contract. 

After the waiting period is over, then full benefits become accessible to you. 

The Basics

The waiting period does not always apply to all benefits; they are usually specific to certain procedures and not routine care The dental insurance waiting periods vary depending on the company Not all dental insurance companies have a dental insurance waiting period Often, employer-based dental benefits plans do not have waiting periods If you had previous dental insurance, you can present the information to your new dental benefits insurance plan provider, and they may be willing to waive the waiting period in cases where there has been no break in coverage. If you are purchasing new dental insurance benefits because you no longer work for the employer who used to provide it for you, you may consider contacting the same benefits plan insurance company and request an individual plan; this may waive the waiting period requirement.

Original: https://www.thebalance.com/dental-insurance-waiting-period-2645722

To find out more about dental insurance no waiting period for major services contact Woody’s Insurance.

Best Dental insurance For Implants

A dental implant (also known as an endosseous implant or fixture) is a surgical component that interfaces with the bone of the jaw or skull to support a dental prosthesis such as a crown, bridge, denture, facial prosthesis or to act as an orthodontic anchor. The basis for modern dental implants is a biologic process called osseointegration, in which materials such as titanium form an intimate bond to the bone. The implant fixture is first placed so that it is likely to osseointegrate, then a dental prosthetic is added. A variable amount of healing time is required for osseointegration before either the dental prosthetic (a tooth, bridge, or denture) is attached to the implant or an abutment is placed which will hold a dental prosthetic/crown.