A patient’s DPPO insurance or Dental Preferred Provider Organization offer dental services to their clients. Depending on the kind of insurance a patient has will determine which dentist they can go to. We accept a variety of Preferred Provider Organization for dental care at our office. People living in the Orange County area can breathe a sigh of relief knowing that our office can assist them with their needs with the help of their insurance.
Certain insurances may allows for patients to receive exams, treatments, and procedures at the dentist office with co payments or no cost at all. If your insurance covers work done by your PPO dentist closest to you, our dental office will help you file a claim.
You don’t need to bring an insurance card into the office during your visit. Just alert someone at the front desk which insurance plan you have, and any information needed. Our office can help you determine whether or not your insurance covers anything our DDS will be doing during your visit, as well as letting you know any kind of copayment that you may have to pay. See more here.
Types of PPO Insurances We Accept
Delta Care
Delta Dental allows for low cost dental services as well as choice of your dentist. With Delta Dental, there are two different PPO plans available to customers including the Delta Dental PPO and the Delta Dental PPO plus Premier plan. In the Delta Dental PPO, dentists are top fee schedules as payments in full and are prohibited from billing and collecting fees in excess of the agreed upon schedule. The Premier plan adds a certain financial security for enrollees and and groups not seen elsewhere.
Members of this plan do have an annual maximum coverage, which is a set amount of coverage they are allowed to use over a certain time period, typically a year. Your annual maximum depends on the kind of coverage you have.
Disclaimer: This information is subject to change on behalf of the insurance company. We are providing this as an informal guide to help you determine which services at our office are covered by your insurance. For more detailed information please visit the insurance’s webpage or contact the customer service or member service number listed on most ID cards. The above logo is property of Delta Dental, Inc.
Aetna
Covers preventive care which includes check-ups, cleanings and x-rays and is almost always completely covered. This insurance also covers a variety of different services ranging from fillings to root canals and crowns.
With this plan members get a choice of deductibles, coinsurance levels, maximums and benefits levels. You may choose between having a self funded plan or insured options.
Members get the option of choosing which dentist they would like to go to. Those who use non-participating dentists will be reimbursed based on the standard negotiated fee only and may be balance-billed by the dentist. Patients may also visit any licensed dentist without having to get a referral.
Disclaimer: This information is subject to change on behalf of the insurance company. We are providing this as an informal guide to help you determine which services at our office are covered by your insurance. For more detailed information please visit the insurance’s webpage or contact the customer service or member service number listed on most ID cards. The above logo is property of Aetna, Inc.
Cigna
Cigna has three different PPO plans which include the Cigna Dental Preventative, Cigna Dental 1000, or the Cigna Dental 1500. In the first plan, there is no yearly maximum, no deductible and all of the preventive and diagnostic services charges. With Cigna Dental 1000, the plan pays up to $1,000 annually after a $50 individual/$150 family annual deductible. The Cigna Dental 1500 is nearly identical to the 1000 plan other than that it pays up to $1,500 annually.
With members in this plan who are seeing in network dentist as well as out of network dentist there is no charge for preventive or routine care after the deductible. For things like Fillings, Extractions, crowns, root canals, surgery, general anesthesia, gum treatment and dental repair,crowns, bridgework, dentures patients pays 25% or 50% depending on service. With this plan you share cost with dental services.
Disclaimer: This information is subject to change on behalf of the insurance company. We are providing this as an informal guide to help you determine which services at our office are covered by your insurance. For more detailed information please visit the insurance’s webpage or contact the customer service or member service number listed on most ID cards. The above logo is property of Cigna.
Bluecross
At Bluecross, there are two different plans: Dental Blue Basic Plan and the Dental Blue Enhanced Plan. In both plan, preventive services are completely covered within the network and 80% covered outside of it (after a six month waiting period for the basic plan). With Dental Blue Enhanced there is a 12 month waiting period for major services.
There is a 20% fee for fillings inside the network and 40% when going beyond the network. The deductibles for individuals are both $25 with the enhanced plan costing $150 per family. Dental Blue Basic has an annual maximum of $500.00 while the annual maximum for Dental Blue Enhanced is $1,250.00.
Disclaimer: This information is subject to change on behalf of the insurance company. We are providing this as an informal guide to help you determine which services at our office are covered by your insurance. For more detailed information please visit the insurance’s webpage or contact the customer service or member service number listed on most ID cards. The above logo is property of Anthem Bluecross.
Metlife
Metlife offers one of the nation’s largest networks meaning that there is less disruption to the plan; there is still the option to go outside the network and still receive great benefits. Negotiated dental fees range from 15% – 45% lower than the average charges with the fees possibly expanding to non-covered services.
Disclaimer: This information is subject to change on behalf of the insurance company. We are providing this as an informal guide to help you determine which services at our office are covered by your insurance. For more detailed information please visit the insurance’s webpage or contact the customer service or member service number listed on most ID cards. The above logo is property of Metlife.
Guardian
The biggest catch in the Guardian’s PPO plan is that you have an average savings of 30%, which allows you to save money on treatments while protecting the health of you and your teeth at the same time. You will also know what your payment will be in advance as a pre-treatment cost estimate will be provided. In the Premier Access plan, everything in the basic plan is available but the savings are far greater.
Disclaimer: This information is subject to change on behalf of the insurance company. We are providing this as an informal guide to help you determine which services at our office are covered by your insurance. For more detailed information please visit the insurance’s webpage or contact the customer service or member service number listed on most ID cards. The above logo is property of the Guardian, Inc.
United Concordia
With Concordia, preventive services are not included in the deductibles; deductibles are $100/300 with an $1,000 annual maximum. For qualifying members, there is 100% coverage for periodontal services. In most non-covered services, there is an average discount up to 30%.
Disclaimer: This information is subject to change on behalf of the insurance company. We are providing this as an informal guide to help you determine which services at our office are covered by your insurance. For more detailed information please visit the insurance’s webpage or contact the customer service or member service number listed on most ID cards. The above logo is property of United Concordia.
Assurant
With the Secure Choice Individual Plan, there are no deductibles, no claim forms, and no annual maximum and has a fixed copayment schedule for Plan Dentists and Plan Specialists.
Disclaimer: This information is subject to change on behalf of the insurance company. We are providing this as an informal guide to help you determine which services at our office are covered by your insurance. For more detailed information please visit the insurance’s webpage or contact the customer service or member service number listed on most ID cards. The above logo is property of Assurant.
United Healthcare
Consumer MaxMultiplier, FlexAppeal Preventive MaxMultiplier, and the FlexAppeal Enhanced are all different kinds of PPOs offered within the United plan. The first option is designed for you to come see us regularly and will give you extra coverage as a reward. That means plan members can get treatments such as cleanings and X-rays, as well as fluoride and sealants for children, without having those dollars deducted from their annual maximum. The entire annual maximum is left for other dental care services, such as fillings and crowns.
With the second option, regular preventative care is the mainstay of this plan as these services will be paid for while taking nothing away from your deductible. There are three major benefits in the third plan which includes additional cleanings for gum treatments, white fillings for back teeth, and dental implants. Each member can choose a combination of four adult cleanings or gum treatments per plan year.
Disclaimer: This information is subject to change on behalf of the insurance company. We are providing this as an informal guide to help you determine which services at our office are covered by your insurance. For more detailed information please visit the insurance’s webpage or contact the customer service or member service number listed on most ID cards. The above logo is property of United Healthcare.
Ameritas
Ameritas offers three different plans including the Value Source, EssentialDental, and $ensibleChoice. Firstly, Value Source offers benefits that are reasonably priced for each individual. EssentialDental allows the customer to get good coverage for all the basic needs at our dental office. The $ensibleChoice bases reimbursement on the dollar amount of your plan member’s expense for dental care.
Disclaimer: This information is subject to change on behalf of the insurance company. We are providing this as an informal guide to help you determine which services at our office are covered by your insurance. For more detailed information please visit the insurance’s webpage or contact the customer service or member service number listed on most ID cards. The above logo is property of Ameritas.
PPO Dental Insurance
PPO dental plans are the more popular types of plans among families and individuals. This kind of dental insurance provides In Network dentist for you but also allows for you to choose a dentist outside their network. There is no referral needed in order to see a licensed dentist for dental work. You are allowed to switch your dentist whenever you choose to without calling your insurance.
There is typically an annual deductible that must be paid before insurance covers dental services. The insurance covers a part of the cost while the patient covers the rest.
You have to pay annual deductible but the amount will depend on which insurance provider and which plan you have. A patient’s annual maximum also depends on which dental provider and plan they have signed up for.