Pacificare(hmo) vs PPO dental? which is better? ?!
Question: Pacificare(hmo) vs PPO dental.? which is better.? .?
i just had my teeth fixed with my current insurance hmo. i paid a lot of money for my crowns. i just to know if i switch to ppo, am i gonna pay the same price or lower price.?
also, can you guys give me additional information about PPO(dental). and why it's better than hmo.? (price)
Health Question & Answer
also, can you guys give me additional information about PPO(dental). and why it's better than hmo.? (price)
Health Question & Answer
Answers:
I'm not really familiar with HMO plans, all the offices that I've worked in (I've been a sub dental assistant, so there have been many offices) only accept PPO plans. PPO plans vary depending on the type of plan. For example, the insurance company, say Cigna, can have 5 different PPO plans. The things you really have to look for are the deductible amount, and the percentages they pay on preventive, basic and major. Usually, they pay between 80%-100% on preventive, basic is between 60%-90%, and major is usually 50%-60%. Some plans pay 100% for preventive, which means, IF the doctor is contracted with that insurance company, you will not have to pay anything out (that's for cleanings and such). If a doctor is NOT contracted with the insurance company, they will pay 100% of the usual and customary fee, and you will be responsible for the difference between that fee and the doctors fee. Typically PPO plans are through employers, although there are some individual PPO plans out there, they are just more difficult to find.
People usually say a PPO is better than an HMO because you get to pick your doctors, rather than being assigned to a doctor.
An example of the fee...Crowns are usually a lot of money, say $800. With a PPO insurance, you will usually have to cover your deductible (it's usually between $25 and $100 - one time fee per year) so we'll say $50 is your deductible, and your insurance covers 50% of basic work. You will be charged $400, plus the $50 deductible, unfortunately that doesn't factor into the work. Your total will be $450 for the crown. I hope that makes sense, I know what I'm trying to say :)Health Question & Answer
People usually say a PPO is better than an HMO because you get to pick your doctors, rather than being assigned to a doctor.
An example of the fee...Crowns are usually a lot of money, say $800. With a PPO insurance, you will usually have to cover your deductible (it's usually between $25 and $100 - one time fee per year) so we'll say $50 is your deductible, and your insurance covers 50% of basic work. You will be charged $400, plus the $50 deductible, unfortunately that doesn't factor into the work. Your total will be $450 for the crown. I hope that makes sense, I know what I'm trying to say :)Health Question & Answer