Let’s Talk Dental Insurance by Desert Dental Group

What’s the difference to you financially when your care is in-network and out-of-network? This information is hyper-critical if you’re thinking about a new dental office or just wanting to get the best out of your benefit plan. Hopefully, this will shed some light on the issue and help explain dental insurance and how insurance works and how your money is spent. Simply put, if the dentist you visit is part of your insurance company’s network, you’ll get more health care value at lower prices. But if you go out of your network for dental care, it can become a lot more expensive.

So it’s important to carefully consider which dental offices are in your plan’s network before you agree to your treatment plan. Here’s an example of how in-network and out-of-network benefits compare in PPO plans. In-network: You go to a doctor and the total charge is $250. You get a discount of $75 because you went to an in-network doctor and our negotiated rate with them is lower. We pay $140. You pay what’s left, which is $35. Out-of-network: You go to a doctor and the total charge is $250. You won’t get a discount because the doctor is out-of-network. We still pay $140, but you’ll be responsible for what’s left, which is $110. We call this balance billing.

Going out-of-network could mean you’ll have to pay a larger percentage of the cost or the total cost, depending on your particular plan. You may also pay a higher coinsurance percentage and have higher annual coinsurance and out-of-pocket maximums. If your company plan is Principal, Met Life, Delta Dental, Cigna or Aetna, please call Desert Dental Group for a free insurance consultation. Ask for Briana or Christi at 520-663-0419, they will explain your treatment options and how your plan can best serve you and your smile.