By: Spirit Dental
June 2, 2015
Updated June 2023
When it comes to dental insurance, there are several types of plans available to consumers. Two common options are PPO and indemnity plans. Understanding the differences between PPO vs indemnity plans is crucial to making an informed decision about which one is right for you.
Many people are confused about their dental insurance options and end up choosing no dental insurance. The common notion is that dental health is expensive, and it is better to pay for dental fees upfront, whenever they need it, rather than pay for something that they feel they won’t be able to make use of. The truth is, it's the other way around. With the right dental insurance plan, you can bring more value to your money and be able to have bigger savings at the same time.
In this article, we'll compare and contrast the features of a dental indemnity plan vs PPO and help you make an informed decision about which one is best suited for your dental insurance needs. Whether you're seeking coverage for yourself or your family, understanding the advantages and disadvantages of these plans and comparing dental insurance can help you get the most out of your dental insurance.
What is PPO dental insurance?
PPO dental insurance is a type of dental insurance plan that operates on a Preferred Provider Organization (PPO) network. Some of the benefits of a PPO vs indemnity include:
- Lower out-of-pocket costs: Patients who choose an in-network dentist typically receive a discounted rate on services provided by that dentist, resulting in lower out-of-pocket costs for the patient.
- Higher level of coverage for preventive care: PPO plans often offer a higher level of coverage for preventive care services like routine cleanings and checkups, making it easier and more affordable for patients to maintain good oral health.
- No need to submit claims: Patients who choose an in-network dentist typically do not need to submit claims for reimbursem*nt, as the dentist will bill the insurance company directly for covered services.
- Coverage for a wide range of dental services: PPO plans typically offer coverage for a wide range of dental services, including basic and major restorative services like fillings, root canals, and crowns, as well as orthodontic services.
What is a dental indemnity plan?
Indemnity plans, on the other hand, do not have network provisions at all. Indemnity plans are known as fee-for-service plans, which means that the policyholder will pay for their dental services upfront and then submit a claim to the insurance company for reimbursem*nt. When you’re comparing an indemnity plan vs. a PPO plan, there are many advantages to an indemnity plan, including:
- More flexibility in choosing a dentist: With an indemnity plan, patients can see any licensed dentist of their choice, without being restricted to a network of preferred providers.
- No restrictions on out-of-network care: Patients who choose an indemnity plan are not limited to in-network dentists, and can receive care from any licensed dentist, with the plan covering a percentage of the cost based on a fee-for-service model.
- No referral requirements: Indemnity plans do not require referrals from a primary care dentist to see a specialist, providing greater freedom of choice and easier access to specialized care.
- Greater predictability of costs: Indemnity plans often have a fixed fee schedule for covered services, which can make it easier to predict and budget for out-of-pocket expenses.
Indemnity plans generally offer greater flexibility, but they may require patients to pay a greater portion of the cost of their dental care upfront and may have higher deductibles and out-of-pocket costs than other types of dental insurance plans.
Trust Spirit Dental to help you understand PPO vs indemnity and find the right plan for you
Understanding what your needs are and comparing indemnity vs PPO dental insurance will help you determine which plan works well for you, and not just for your budget, but for your expectations and requirements overall. If you’re curious about your insurance options and what Spirit Dental & Vision can offer you, contact us and get a dental insurance quote today.
