Dr Dental, Getting the best value under a PPO plan.
When buying a PPO plan using the plan network of providers is normally going to provide you greater value. Although most PPO plans do provide benefits for outside net work dentist (dentist not a provider of the plan) they will in some cases reduce the coverages provided under the plan for non provider use. Such as maybe the plan pays 100 percent for preventive care with plan providers but only pays 80 percent when you choose a dentist not in the plan network of providers. Even if the PPO plan you are reviewing dose not reduce their benefits for out of network dental providers, you still run a risk of having a greater chance of UCR(Usual, Customary and Reasonable) fees. Since inside network providers have mostly agree to reduce their cost to stay within the plan UCR rates and non provider have made no such concession.