Learning More About a Typical Dental PPO Plan

There cannot be any alternative to providing proper care and maintenance to your teeth and gums for their well-being. Hence, if you avoid seeking dental services primarily because of the concern about the cost, you must find a solution to this and make your appointment with a professional dentist for help. Insurance can be the best fit when you wonder about managing the treatment cost. You get different dental plans, such as HMO, DMO, and others. However, most reputable clinics prefer PPO plans. Dental PPO designs could be the thing if you don’t know where to begin your search.

A typical PPO plan allows you to seek medical assistance from any in-network or out-of-network dentist, which is its unique benefit. While in-network dental service providers charge lower rates, others’ services will likely cost you the same as the standard procedure rates. That’s why choosing an in-network doctor is an intelligent decision. When exploring your PPO plan with different carriers, pay attention to a few things: deductible, annual maximum, services covered under a plan, coinsurance, etc. These will guide you on whether a specific financing option is suitable for your need or not. 

Variables in dental PPO plan

Suppose you choose Cigna because of its popularity. You can look for a 10010 Cigna PPO Dental office for help. But how do you know your Cigna insurance policy is a good fit? For this, you will want to study the following factors:


Most PPO plans involve a yearly deductible, which you pay out of pocket before your insurance provider, such as Cigna or someone else of your choice, begins to pay for covered services. For example, if you have a USD $500 deductible, you will pay the first USD $500 of one of the covered dental services’ expenses. After you fulfill this requirement, your insurer will start to pay for covered services. Some insurance plans may have a deductible for each type of coverage, while others can feature a single deductible for all coverage types.


Most PPOs can have this component. But what does this component signify? It means the insurer and policyholder will share the treatment expenses covered under the plan. You need to sift through the terms and conditions of your PPO to understand how much cost you will bear. You may have to take care of a certain percentage of the total amount, while your insurer, such as Cigna, may pay the remainder. More precisely, if a service costs you USD $100, you may have to pay USD $20, and the company would pay USD $80. It is just an example, though.

Annual maximum

It refers to the highest limit or amount an insurance company will pay in a specific year for your medical treatment. Once you reach this limit, you will bear the additional costs. That’s why you have to pay attention to this detail closely. If you have a lot of medical expenses in a single year, you would want to plan well. 


Copay refers to a fixed sum of money you pay for your treatment during your visit to a dentist or while getting the prescription. When using the healthcare service, you pay a pre-determined amount, such as USD $20, and your insurer covers the rest of the billing amount. A Cigna PPO plan sometimes factors in this component. 

Waiting period

Few dental policies come with a waiting period, due to which you may not be able to enjoy the coverage benefits immediately after your enrollment. Your PPO plan can also have this, but it’s better to confirm. It can be more relevant for non-preventive care.

Typical dental services under a PPO plan!

Knowing about this aspect is crucial as these variables affect your out-of-pocket cost. 

Preventive care

You can be happy to learn that almost all PPOs cover the total cost of preventive care, including specific X-rays, oral tests, teeth cleaning, sealants, and fluoride treatments. But you have to find out how many services can be accessible in a year and the eligibility in terms of age. For restorative services like tooth extractions, root canals, and fillings, your Cigna PPO plan may require you to take care of your deductible first. After this, you may have to pay just a portion of the total cost of the covered services. But remember there can be an annual maximum on this.

Restorative work

Some people may need dentures, bridges, or crowns. Or, one may require gum grafts or oral surgery to treat a specific dental condition. These are major dental restorative works, which can again be a part of your PPO plan. But remember, it will likely cover only a specific part of the bill. Hence, it’s also good to be clear about this thing from the beginning.

Orthodontic care

Some plans can also pay for your orthodontic care, including braces. But you have to check the age limit. Then, if the deductible applies, you will have to look after that before the plan starts sharing the medical bill. After this, you and your insurance plan will share the cost of the covered services up to an annual maximum.

The main benefit of a PPO plan is accessibility to both in-network and outside-of-network dentists. With this, you save on your dental services covered under the plan. And some preventive care services can be available at a lower to no cost at all. Hence, it is a wise thought to enroll in a plan that offers you this and much more. However, before jumping to any specific scheme, compare your options. When you make an informed decision, you benefit the most. You can have your treatments hassle-free and tension-free because you know the insurer will take care of the excess burden. 

Dental health has to be a priority. If you feel discomfort or uneasiness, it’s better to seek expert advice and get treated – the early, the better. Most troubles can be easy to resolve at an early stage. It helps you curb the progress of the issue while costing less too.