Dental insurance can be a wonderful provision that greatly reduces the out-of-pocket cost of high-quality care. As 2025 winds down, you might be thinking about purchasing a policy for the new year, or perhaps you are weighing the possibility of selecting a plan that is different from your current one. What should you know as you are shopping for dental insurance? This blog post provides some helpful information.
Consider Choosing a PPO Plan
One of the most popular types of dental insurance is the Preferred Provider Organization (PPO) plan. With a PPO, you have the flexibility to see both in-network and out-of-network dentists, though staying within the network usually means lower costs. PPO plans often balance affordability with choice, so you do not have to sacrifice the ability to visit your favorite practice.
In contrast, other types of dental insurance often require you to stay in-network, which can be very inconvenient.
Know What Is Covered
Before you select a dental insurance plan, review the list of covered services. Most policies cover preventive care, such as cleanings and exams, at little or no out-of-pocket cost. However, coverage for restorative procedures like fillings, crowns, or root canals can vary quite a bit between plans. Some plans may also include orthodontic care, but this is not always the case. Reading the details carefully will help you avoid surprises when you need dental work.
Understand Coinsurance and Deductibles
Dental insurance plans typically require you to pay for a portion of your care through coinsurance and deductibles. The deductible is the amount you pay out of pocket before your insurance begins to share costs. After the deductible is met, coinsurance determines what percentage of the bill you pay and what percentage the insurance covers. These amounts can differ between basic and major services (for example, basic services may be 80% covered, while major services might be just 50% covered), so take time to compare the fine print between different plans.
Look at the Annual Maximum
Every PPO dental insurance plan sets an annual maximum, which is the total amount that the insurer will pay for your care in a plan year. $1,000 is a common figure for an annual maximum, but some plans offer a much higher limit. Once you reach your annual maximum, you are responsible for any additional expenses until your benefits reset in the new year. Plans with higher annual maximums may cost more, but they can offer greater value if you anticipate needing extensive dental work.
Analyze Your Family’s Needs
When shopping for dental insurance, you should account for the unique needs of your household. If you have children who may require orthodontic treatment or if someone in your family needs frequent dental procedures, look for plans that provide coverage for those specific services. Think about both your current oral health and any possible future issues. Taking a close look at your family’s dental history and anticipated care will help you choose a plan that supports your overall well-being.
Shopping for dental insurance requires you to pay close attention to the details! Choosing the right plan can make it much easier to maintain a healthy smile without breaking your budget.
Meet the Practice
At Family & Implant Dentistry of Stuart, our team is proud to welcome PPO dental insurance. We are pleased to help patients understand their benefits and maximize the value of their plan, all while providing top-quality oral health care. If you would like to learn more about how we can assist you with the process of using your insurance, contact our office at 772-286-3088.