Preferred provider organization (PPO) dental insurance plans are an ideal way to get the coverage you need without sacrificing your oral health. You can sign up right away if you don’t have access to dental coverage, and the premiums are affordable.
Wondering how to find a policy that best suits your needs? Let Benzinga lend a helping hand. Here’s a breakdown of PPO dental insurance and what it covers. We’ve also included a list of what to look for in a provider and the top dental insurance companies that offer PPO plans.
Best PPO Dental Insurance:
- Best Overall for PPO: Delta Dental
- Best for No Waiting Periods: Spirit Dental
- Cheapest PPO Dental Insurance: Humana
- Best for Customer Service: Cigna
- Best for Discounts: DentalPlans.com
What is PPO Dental Insurance?
PPO plans afford you the flexibility to receive dental treatment from an extensive network of providers at a reasonable cost — and you won’t have to choose a primary care dentist.
In most instances, you’ll be assessed a percentage of the bill at the time services are rendered, which is also called coinsurance.
The good news is that providers agree to a negotiated, contracted rate for services that are much lower than it would be if you didn’t have coverage, so the cost savings will be passed on to you.
You can also see a provider that’s outside of the network, but your out-of-pocket costs will be higher.
Types of Dental Coverage
Coverage extends to preventive care, basic procedures and major procedures. Most dental insurance providers abide by the 100/80/50 rule:
- Preventive care, like checkups, diagnostic services, cleanings, exams and X-rays, are 100% covered.
- Basic procedures, including medically necessary services like extractions, fillings and periodontal work, are covered at 80%.
- Major procedures, including bridges, crowns, dentures, emergency surgeries, implants and root canals, are 50% covered.
Not all plans offer coverage at these levels, though. You may be covered at a lower rate, which equates to higher out-of-pocket costs. Consult with the provider you enroll with to confirm.
Average Cost of PPO Dental Insurance
As you shop for PPO dental insurance, there are 2 types of expenses you should be mindful of — premiums and out-of-pocket costs.
Premiums are the amount you pay each month to keep your plan active. They range between $20 and $50, depending on coverage levels, deductible and annual plan maximums.
Out-of-pocket costs include:
- Coinsurance, or your portion of the dental fees. If 80:20 coinsurance applies to the service you’re receiving and the total bill is $1,000, you’ll be responsible for $200 and the insurance provider will pay the remaining $800.
- Copayments, or the amount you pay before receiving treatment, are fixed and only apply to select services.
- Deductibles, or the amount you pay before your plan kicks in for services not covered at 100%.
Be mindful of the annual maximum. Any fees billed for services that exceed this amount will be your sole responsibility.
Worried about the cost of coverage? You can retrieve free rate quotes from multiple providers so you’ll know what to expect before you enroll.
What to Look for in a Dental Insurance Provider
Several dental insurance providers offer PPO plans, which makes it challenging to narrow down your options. If you’re not an insurance guru, how can you decipher between plans that may work for you and those that should be removed from your list?
Easy — the best dental insurance providers meet the following criteria.
Flexible Plan Options
You want coverage that caters to your specific needs. Consider a dental provider with flexible plan options for every lifestyle.
Does the plan offer coverage for preexisting conditions, or are these services excluded? Read the fine print or inquire before you enroll. The best dental insurance providers feature plans with very few exclusions, which could save you cash over time.
It’s frustrating to purchase dental coverage only to find out a lengthy waiting period applies before you can receive services. Do yourself a favor and avoid plans with pesky waiting periods, particularly if you need basic or major procedures sooner than later.
Affordable dental insurance is pertinent if money’s tight and you have a load of other expenses to worry about. Look for providers that don’t require you to skimp on coverage in exchange for cost savings.
Does the provider feature steep deductibles, copayments and coinsurance? Unless the premiums are low and help offset the costs you’ll incur, it’s probably best to shop elsewhere.
The reputation of the dental insurance provider should be another significant factor in the evaluation process. You want a provider that prides itself on exceptional customer service, affordability and rapid claims processing, just to name a few. Check to see if it’s won accolades and peruse reviews from past and current subscribers to learn more.
Best PPO Dental Insurance Providers
Ready to enroll in a plan? Here are the top PPO dental insurance providers.
1. Best Overall: Delta Dental
Delta Dental has been a top choice for dental solutions among consumers for over 50 years. It’s the largest provider in the nation and offers affordable PPO plans to achieve and maintain better oral health.
Its PPO plans feature 100% coverage for preventive cleanings and check-ups. You’ll also have access to an extensive provider network. The Delta Dental PPO Plus Premier plan lets you see network providers and still receive the same great coverage without all the added fees.
Join over 80 million subscribers that have chosen Delta Dental to meet their dental insurance needs.
2. Best for No Waiting Periods: Spirit Dental
Spirit Dental is a popular choice for insurance coverage if you want an option with no waiting periods. The company currently serves over 100,000 subscribers with its dental plans including Spirit Network Dental Insurance and Spirit Choice Dental Insurance.
Both plans offer the following benefits:
- Preventive coverage at 100%, which includes 3 cleanings per year
- Coverage for implants and major services
- A deductible of only $100 and an annual maximum of $5,000
- Orthodontic coverage (kids only)
The Network plan requires that you choose from a select list of providers but the Choice plan allows you to visit any dentist. Seeing an out-of-network provider means you’ll pay more for care.
3. Best for Affordability: Humana
Humana removes the stress from paying for dental care by offering affordable coverage options for every budget.
Starting at $16.99 per month, PPO plans feature:
- Low deductibles
- Zero waiting periods for preventive services
- Coverage for basic services and some major services
- Discounts on orthodontic care and select major services (varies by state)
As a subscriber, you’ll also have access to a vast network of over 270,000 providers. Learn just how affordable dental coverage can be by getting a free quote from Humana.
4. Best for Customer Service: Cigna
For as little as $19 per month, you can get dental insurance coverage from a provider who cares. Cigna’s PPO plans are the preferred choice for over 15 million consumers throughout the U.S., and Cigna has customer service representatives standing by 24/7 to assist you with your dental care needs.
Cigna also offers a sizable provider network of over 90,000 dentists at over 286,000 locations. What really sets it apart from other dental insurance providers is its Brighter Score feature, which allows you to analyze providers based on ratings by affordability, professional history and patient experience.
Get started with Cigna by requesting a free online quote or call 1-800-997-1654.
5. Best for Discounts: DentalPlans.com
DentalPlans.com doesn’t offer dental insurance, but its discount plans are definitely worth considering if you want to receive treatment from reputable providers and keep the costs down. To date, over 100,000 dentists around the nation accept these plans.
Here’s how it works:
- Choose from one of 30 dental savings plans from leading insurance providers, like Aetna, Cigna and Delta Dental.
- Show up for your appointment and present your membership card. You’ll save up to 60% on covered dental procedures if the provider is in the DentalPlans.com network.
- Pay the discounted rate for your treatment without worrying about exclusions or preexisting conditions.
There are no copayments, coinsurance, deductibles or annual maximums. Plus, you won’t ever have to submit a claim for reimbursement as discounts are applied right away. You may also be eligible for cosmetic dentistry services.
If you already have a preferred dental provider, reach out to determine whether your dental provider accepts discount plans.
Get PPO Dental Insurance Today
Brushing and flossing your teeth daily is a great way to stay on top of your oral care. You also need routine care from a professional dentist.
Finding the perfect PPO dental insurance plan to help offset costs doesn’t have to be complicated or overwhelming. Let us help you identify the ideal plan for you.
Start by getting a free quote from one of our recommended providers. It only takes a minute of your time and you can explore plan options at the tap of a fingertip.
Frequently Asked Questions
1) Q: How does dental insurance work?
A: A dental insurance plan charges a premium in exchange for covered benefits. Unlike health insurance plans, dental insurance plans usually have a cap on benefits, which means your plan may stop providing coverage once you reach the annual cap, often between 1k and 3K. Like other types of healthcare insurance, dental insurance focuses coverage on essential services, like cleanings, fillings, etc. Many plans don’t cover braces or elective cosmetic procedures. Get the cheapest premium here.
2) Q: Is dental coverage part of health insurance?
A: Some health insurance plans bundle dental coverage as well but, in many cases, dental insurance is a separate plan. Healthcare plans that are ACA-compliant are required to offer dental coverage to children but there is no requirement that adults have dental insurance coverage. Choosing a separate dental insurance plan can be a cost-saving step and helps make dental health costs more predictable. Check out our best providers for the cheapest rate.
3) Q: What kinds of dental insurance are available?
A: Your choices for dental insurance plans are similar to health insurance choices. You can choose from a dental HMO, which helps to keep premium costs low by keeping services within controlled network. Dental PPOs give more freedom to choose your dentist and care but cost more than HMO plans. A third option is called a dental indemnity plan, which pays a fixed amount or percentage for covered services. Compare quotes from our top providers for the best price.
Did We Say Discount?
DentalInsurance.com is a wholly-owned subsidiary of Kelsey National Corporation (KNC). A leading provider of dental insurance, DentalInsurance.com was the first to let individuals comparison-shop and apply for dental insurance and discount dental plans online.
DentalInsurance.com provides families, individuals and business owners with the easiest way to compare and purchase affordable, quality dental insurance and discount dental plans.