Maximizing Your Savings: Tips for Using PPO Dental Insurance

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While savings come naturally for many, others may need help to meet their goals. Whether saving for a new home, an annual vacation, or a major dental procedure, establishing positive habits can help you reach your goals. Dental insurance plans are complicated and often have many terms unfamiliar to the average person, including deductibles, copayments, and annual maximums. Using your insurance benefits to the fullest is vital to getting the most out of your coverage.

See an In-Network Dentist

When you choose in-network dentists, you will enjoy the most significant savings on your dental care. Preferred provider organizations have negotiated fees with dentists, that are typically lower than their usual, customary, and reasonable (UCR) rates. These discounted fees are what insurance companies pay for the services provided by in-network dentists. Most dental PPOs also have a fee schedule that covers a percentage of specific procedures up to an annual maximum.

When looking for PPO dental insurance in California it’s essential to consider your budget when choosing a plan. Ultimately, your employer or health insurance broker will help you make the best decision. If you have an FSA or flexible spending account with a balance you will lose after the year ends, it might be a good idea to use it for your dental needs before the end of the year. If you plan to undergo extensive treatment, it might be beneficial to do so in stages to maximize your benefits.

Schedule Your Appointments Early in the New Year

You have until the end of 2023 to use up any unused dental insurance benefits before the start of the following year. The amount that the insurance company will pay for approved services within a calendar year is the annual maximum for most dental plans. This limit does not roll over into the following year so that any unused benefits will be lost. Schedule your appointments as soon as possible if you have any unused benefits left. It also applies to any required preventive appointments, which should be planned regularly to guarantee oral health and identify problems before they worsen. Most PPO dental insurance plans cover these visits at no cost or with minimal co-pay. It’s a great way to maximize your savings!

In addition, it’s a good idea to use up your unused benefits before the new year because of the many deductibles and co-pays set at the beginning of the year. If you need a significant procedure pushing you past your annual maximum, consider scheduling the first part of it late this year and finish it in January. It will allow you to leverage two annual maximums and save even more money!

Look for Discounts

When comparing dental plans, ask about the size of their network. Generally, a PPO network offers better discounts. Also, check out the plan’s care agenda to see what services are covered and at what co-pay level primarily, and look at the average effective discount that enrollees enjoy. With the onset of Obamacare, many groups opt out of their traditional dental insurance and prefer to purchase a discount dental plan instead.

While you still have to deal with deductibles and out-of-pocket costs, the savings can be significant. Another benefit is that most dental discount plans don’t reset at the end of each year like a traditional insurance policy. However, determine if the unused portion of your annual maximum will carry over into the following year. Otherwise, you will need to purchase a new plan.

Consider a Flexible Spending Account

If you have a flexible spending account, also known as flex spending or FSA, which is an account that you establish through your employer to have some of your pre-tax pay put into, you can use that money to help cover dental expenses. Like most FSAs, those funds will expire at the end of the year, so you’ll want to ensure you’re using them up before then. Most PPOs have an annual maximum that they’ll cover for a plan year, and if you need to get a major procedure done, it’s essential to keep that in mind when deciding how you will spend your flex spending or FSA money. Talk to your dentist about the annual maximum for your plan and any limits associated with specific services you’re considering. Ask them to see if they can schedule the procedure over two years to get you past the annual maximum. Another option for getting more bang for your buck when using your PPO dental insurance is to consider attending a dental school rather than an established private practice. Typically, you’ll pay 30 to 40 percent less at a dental school than at a private practice for the same services.