The Difference In Dental Plans: PPO VS Indemnity

When it comes to dental insurance there are two types of dental plans. Determining which plan is best for you is easier if you understand the differences in the two types of dental plans.

PPO

PPO stands for Preferred Provider Organization. In a Preferred Provider Organization you'll still be able to select your own provider but it must be within the list of preferred providers or you'll have to pay a lot more money.

The dental insurance company and the preferred providers work together to help keep your costs reasonable. If you go out of network you will lose that benefit and likely be paying a bit more out of pocket for the services you have done.

Most preferred providers work within a group setting such as a health care facility or group in your local area. By joining in with such a group they are able to help keep costs down and pass that savings on to you the consumer.

Indemnity

An indemnity plan on the other hand, allows you the consumer to choose from any provider that you desire. However, you will lose some of the savings that you have with the preferred provider because they aren't under the same contract to provide services at a specific rate.

The indemnity plan will pay a flat rate that is pre set for services. For example: If you have your teeth cleaned they will pay a pre set rate for the cleaning, anything over that pre set rate the consumer will have to pay for.

Each service will have its own pre set rate and the consumer will be responsible for all fees over that rate. Some dentists won't bill an indemnity plan and the consumer must pay the fees out of pocket and then submit the reimbursement forms to the indemnity company themselves.

Choosing between the two plans can be challenging at best.  If you have great teeth and only need minimal dental care you may be able to get along just fine with an inexpensive plan that covers a few fillings and an annual cleaning. However, if you have more serious dental needs you may want more comprehensive coverage.

If you live in a more rural area your options may be limited for PPO care providers. If you aren't able to drive the required distance to reach one of these providers you may need to opt with the indemnity plan for convenience sake.

You'll also want to make sure you read the fine print and know how much you're paying out each month in premiums. You'll want to understand the co payments and what you'll be responsible for in the fees as well.

Once you determine which plan will work best for your needs you can then explore the various PPO and Indemnity policies that are available. Always read the fine print and make sure that you understand the details of your policy before you sign the paperwork and make your first premium.