When it comes to navigating your dental insurance, there are few things in the world that are harder to do! Your benefits may not be crystal clear, and you may not have a lot of in-network options in your area that provide what you’re looking for. But you don’t have to let your insurance plan dictate who you see. If you have a PPO plan, you can visit someone who’s out-of-network, but who will still maximize your benefits. Read on to learn more about choosing an out-of-network dentist in Dallas and what that means for you.
What’s the Difference Between In-Network & Out-of-Network?
If you have a PPO (Preferred Provider Organization) plan, you have a much wider range of dentists in your area to choose from. This is because, while your plan does have a network of offices that they are contracted with, they don’t restrict you to seeing them (like an HMO plan would). Your benefits will expand outside of your insurance company’s network, allowing you to visit fee-for-service offices or out-of-network dentists to get the services you need with fewer restrictions.
If you stay in-network, that just means that the dentist has negotiated discounted contract rates with your insurance company, so you may get savings passed on to you. If you visit an out-of-network dentist, it means that they are not contracted with your insurance company, but they will still bill them on your behalf after your visits.
Is It More Expensive to See an Out-of-Network Dentist?
It’s difficult to say for sure whether staying in-network will actually help you save money, and the answer to this question largely depends on the dental office you’re going to. However, in many cases, the savings associated with seeing an in-network versus out-of-network dentist are marginal. Out-of-network dentists will ask you to pay for the remainder of a treatment left after insurance has provided them with their estimated coverage. So, there may be some trade-offs you will need to weigh.
Are There Any Benefits to Visiting an Out-of-Network Dentist?
There are several benefits of seeing an out-of-network dentist, but one of the biggest ones is usually the quality of care that you’ll be receiving. When a dentist is out-of-network, it typically means that they aren’t as governed by what dental insurance will and won’t pay for when they create your treatment plans. This means that they are more likely to tailor your care to what you personally need versus what they feel insurance will be more likely to cover.
Many patients opt to see out-of-network providers because they feel they receive a higher standard of service than their health plan’s in-network dentists will give them. Additionally, there’s always the risk that someone who you or your family has a relationship with goes out-of-network with your insurance plan, which is happening more often with dentists because insurance companies are paying less and less for care. Instead of having to switch over your care and rebuild a relationship with an office from scratch again, there are a million reasons why you would choose to stay with the same provider!
If you aren’t confident that seeing an out-of-network dentist is right for you, it could be helpful to discuss how your benefits would differ by calling the out-of-network practice you’re interested in visiting. Many practices have accommodating policies to make sure that the difference in cost is minimal.
About the Practice
At Dental Center of Lakewood, our team strives to make navigating dental insurance benefits as stress-free and easy as possible by filing claims on our patients’ behalf. While we are not in-network with any insurance plans, we want our patients to take advantage of their benefits and savings and are happy to work with any and all PPO plans. For questions about in-network versus out-of-network coverage or to schedule an appointment, visit our website or call 214-823-5253.