How to Maximize Your PPO Dental Insurance for Implants & Crowns

Major dental care, such as dental implants, crowns, and oral surgery, is a vital investment in your health. However, navigating PPO dental insurance can be confusing. Understanding how deductibles, annual maximums, and pre-determinations work can help you save thousands on your care.

How PPO Dental Insurance Categories Work

Most PPO insurance policies follow a 100/80/50 coverage structure:

* Preventative (100% Covered): Cleanings, routine exams, and basic X-rays. Usually has no deductible.

* Basic Procedures (80% Covered): Simple fillings, basic extractions, and deep cleanings (scaling).

* Major Procedures (50% Covered): Crowns, bridges, root canals, oral surgery, and dental implants.

Staging Treatments Across Calendar Years

PPO plans have an annual maximum limit (usually between $1,500 and $2,500). Once you hit this limit, the insurance company will not pay for additional care until the plan resets (typically on January 1st).

For comprehensive treatments, we can stage your appointments. For example, we might place a dental implant root in November, utilizing your current year's maximum, and place the final custom crown in January, using the new calendar year's benefits.

Pre-Determinations: No Financial Surprises

Before starting any major procedure, our billing team submits a Pre-Treatment Estimate to your PPO provider. This outlines exactly what the insurance is projected to cover and what your exact out-of-pocket obligation will be.

If you have questions about your coverage or wish to explore interest-free financing through CareCredit or Cherry, contact AVF Dental Group in Aliso Viejo at (949) 360-9700. We accept most major PPO plans.