There are many dentists that do not take any insurance or accept a very limited number of plans. You do not want to switch to a different dentist but you want to have insurance. These plans will allow you to go to any dentist in the United States. It will not matter if they are in or out of network, or even accept insurance.

Dental Plans Where I Can Use Any Dentist

When a dentist accepts insurance as a network provider, they have agreed to use the network's discounted rate fee schedule. They cannot charge higher fees for any listed procedure. In simple terms, they have agreed to give you a substantial discount.

Needless to say, many dentists do not like giving discounts and have decided that they will not take any insurance at all. While they will submit claims to your insurance company for you, they expect to be paid up front.

In almost all instances, if you use a network dentist, you will save money.

This sounds good in theory, but many of you do not want to change dentists. You don't care what they charge, you are not going anywhere.

You don't have to change dentists. We can provide dental insurance that will permit you to use at any dentist.

How These Plans Work

There are two types of plans that will give you the freedom to use any dentist; PPO and Indemnity.

Using a PPO Plan with Out of Network Dentists

Even though your dentist is not contracted with an insurance carrier and does not have to accept a plan's network rates, they can still submit a claim for you. But what does this mean?

When a dentist submits a claim to the insurance carrier, they list the codes used for your treatment. Every procedure performed has a special American Dental Association (ADA) code. The insurance company looks up what a contracted dentist would have charged and pays you based on that rate. They do not pay based on what the dentist charged you, unless it was the same as the contracted rate.

That is why dentists tell you to get a PPO plan. They know they can just submit the claim and not be held to the discounted rates. They can still charge you whatever they like.

I just wanted you to understand how this works. It is not uncommon for us to get a call that goes something like this "I have your PPO plan and you said it will cover major work at 50%. My wife had $1,400 root canal and I got a check for $275."

Here is what happened. The dentist submitted the claim to the insurance company. The PPO negotiated rate for a network dentist was $550. The insurance company paid 50% or $275. Now that you understand this, let's look at another alternative that might offer fewer surprises.

Using an Indemnity Plans with Out of Network Dentists

An indemnity plan is a dental plan that pays you or the dentist specific amounts based on the procedure codes your dentist submits in the claim. With the PPO you were shown how much you would pay the dentist.

With an indemnity plan has a chart of all the different procedures the dentist might perform, which is very similar to a PPO. However, in this case, instead of telling you how much the dentist can charge, the chart tells you how much the insurance company will pay you or the dentist.

A fast example will make this all clear.

Your dentist needs to do a filling and tells you that it will be $150. You pay the dentist the $150 and give him your insurance card to file the claim.

1. You have a PPO - the plan sees that the discounted or reasonable and customary rate for dentists in your area for the filling is $100. They are paying 50% with this particular plan and you get a check for $50 or half of what you would have paid a network dentist. You are out of pocket the difference of $100 (or $50 if the dentist was in the network).

2. You have an Indemnity plan - looking on the chart with all of the covered procedure codes we see that this plan will pay out $80 for this type of filling. You get a check for $80. They don't care what was charged, only that the work was performed.

If you are going to go to a dentist that does not take your insurance, we find that you are usually better off with an indemnity plan.

A Dental Plan That You Can Use With Any Dentist

This plan is available in most states and we find it to be the most cost effective dental insurance plan we sell.

Core Dental with Ameritas PPO Network

Core Dental's top plan has higher limits than any other plan, providing coverage of up to $2,500 per year. It will cover preventative, fillings, simple extractions and denture repair with no waiting period. Major procedures have a 6 month wait. If you can wait the six months, no plan offers a higher benefit and it includes a great vision plan for no extra cost.

If this plan is available in your state, we think you should strongly consider it if you need a lot of work. When using the link you will be taken to their site. There is a box on the lower right that says View Plans & Rates. You only need to fill in the information in that section. So not worry about the rest of the page.

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