Whether you’ve obtained your private insurance coverage through Covered California or were provided it via your workplace, there is often affordability attached to having reliable access to top-quality dental care when the need arises.
When choosing dental insurances, the biggest consideration is whether you are optimizing for your choice of the provider (dentist, physician, etc) that you want to go to, or, you want to optimize for finances.
PPO (Preferred Provider Organization) vs HMO (Health Maintenance Organization): If you choose a PPO plan, you have a choice to see any provider that you please and your plan will compensate for the visit. If you choose an HMO plan though, you have to be seen by the provider that you are assigned to by your insurance plan. HMOs reduce the patients out of pocket fees while PPOs provide flexibility & choice.
The concept of “in-network” vs “out-of-network” refers to whether the provider of choice is in contract with the insurance carrier as well as the type of plan or not- essentially, whether the provider is setting their own fee-schedule for services being rendered or that they are abiding by the fee-schedule set by the insurance companies for services being rendered.
It is possible to see a provider that is “out-of-network” with your PPO insurance plan; what that could mean, relative to seeing an in-network provider for your PPO plan is the compensation level by your insurance plan for the same services rendered.
You can’t do that with HMOs though; so, if you are subscribing to an HMO plan, you have to be seen by a provider that is in contract with the HMO plan; otherwise, you’d usually get no compensation for your visit to that provider (there are some exceptions to this rule as always).
Here are some of the bigger insurance carriers in the market at this point: Delta, MetLife, Cigna, Guardian, Anthem, Blue Cross and Aetna. These companies provide both HMO as well as PPO options to patients.
Delta currently has the largest network of participating providers in the nation. It is a conglomerate of several smaller insurance companies that have over-time been merged together.
Soothing Dental San Francisco
Dental insurance can be puzzling; nonetheless, it is crucial that you understand the specifics of your plan to make the most of its advantages. We accept all dental PPO plans and can bill them on behalf of our patients. We can’t bill any HMO plans though.
We do offer our in-house plans for those who are interested in being our patients while not having any commercially available dental insurance or that they have HMO plans that can’t be billed.
We also provide patients who do not have an active insurance plans with flexible payment alternatives when they need treatments at our San Francisco office.
Our team of expert dentists and hospitable staff prioritize meeting the oral needs of patients spanning all age groups. Schedule your appointment by reaching us at 415 989 3953.