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Dental Preferred Provider Organization Plans |
The chief distinguishing feature of a dental preferred provider organization (DPPO) insurance plan is that it allows an insured patient to choose any dentist. This is regardless whether that dentist is a member of a dental PPO network or not.
In a dental preferred provider organization insurance plan, an insured patient can get full benefits of dental care from a dental care provider, who is a member of a specified preferred provider organization panel. This is in exchange for a monthly premium to be paid by the insured person to a DPPO insurance provider.
Further, an insured person, who joins a DPPO plan through his/her employer, may get additional benefits. This is because some employers contribute a part of an employee’s monthly insurance premium in respect of these plans.
The full benefits are in the form of comparatively shorter wait times for preventive and basic care, lower premiums, lower deductibles, and lower co-pay than is applicable in the case of other indemnity plans. However, a ceiling on the yearly insurance claim amount exists.
The other distinguishing aspect of this plan is that only partial loss of full benefits is suffered by the insured patient. This loss is in the form of comparatively higher deductible, higher copay, and in certain cases even higher premiums charged by an insurance provider from an insured person under the plan.
A dentist, who is part of the panel, is paid fee for service by the insurance provider. This fee is substantially less than the fees charged by the dentist in the case of a non-insured patient.
From the point of view of the dentist, the advantage of this is in the extra clientele he/she can get to help boost his/her practice. Further compared with other indemnity plans, dentists prefer this plan. This is because under it trouble-free payments are made quickly by an insurance company to them.
To non-DPPO member dentists, the plan provides benefits in the form of patient referrals. Therefore, they charge insured patients less than the usual fee charged by them in the case of non-insured patients.
Dental preferred provider organization insurance companies are regulated by state insurance statutes.
DPPO plans are characterized by less paperwork, quick payments, and flexibility in the choice of dentists.
Some drawbacks of PPO plans have also been observed. The drawbacks include refusal by DPPO member dentists to see patients in the case of frequent expensive procedures which could entail monetary loss by the dentists concerned.
They also include higher monetary outgo from the pocket of an insured person due to deductibles adding up in the case of family DPPO plans. They also include an inadequate yearly insurance cap amount due to which patients may have to pay out of pocket expenses for costly procedures such as root canal treatments.
Therefore DPPO plans are most suitable for individuals who want minimum paperwork, whose employer contributes to the plan, and whose dentist is already a member of the DPPO. |