PPO Dentist for Kids
PPO Dental Insurance
A patient’s DPPO insurance or Dental Preferred Provider Organization provides dental services to their clients. The kind of insurance a patient has determines which dentist they can go to. We accept a number of Preferred Provider Organization for dental care at our office. Our office can assist patients with their dental concerns with the help of their insurance.
Certain insurances may be able to cover exams, treatments, and procedures at the dentist office with co payments or minimal cost. Our dental office will help you file a claim if your PPO insurance is able to partially or fully cover your dental service.
Bringing an insurance card into the office is not required for your visit. Just inform a member of the front desk staff of which insurance plan you have, and any other information needed. Our office can help you find out whether or not your insurance covers any service our DDS will be performing during your visit, as well as notifying you of any kind of copayment that you may need to pay.
Kinds of Insurance We Accept
Healthfirst members can get high quality dental care through their partner DentaQuest, with services that include dental checkups, cleanings, x-rays, fillings, and more. DentaQuest uses an “open network.” Meaning that members can choose and visit any dentist that takes Healthfirst or DentaQuest. Health First Essential Plans Plus Vision & Dental include coverage for checkups, emergency care, prescription drugs, dental and vision services, 24/7 access to telemedicine, and more, with no annual deductible.
Affinity Health Plan Medicaid, Child Health Plus, Family Health Plus, Medicare, and Affinity Essentials Qualified Health Plan Members are covered for dental care through our dental plan administrator, DentaQuest. Regular and routine dental services, supplies and devices are covered and members are able to pick their own DentaQuest dental provider, or, if they do not have a preference, a dental provider is assigned. Members can contact DentaQuest at any time to change their primary dentist or get help with making a dental appointment.
Consumer MaxMultiplier, FlexAppeal Preventive MaxMultiplier, and the FlexAppeal Enhanced are all different kinds of PPOs offered within the United plan. The first plan is designed for you to come see us regularly and will provide you with extra coverage as a reward. That means that plan members can get services like cleanings and X-rays, as well as fluoride and sealants for kids, without having money deducted from your annual maximum. The complete annual maximum is left for other dental work, such as fillings and crowns.
With the second option, regular preventative care is the mainstay of this plan as these services will be paid for without taking anything from your deductible. There are three major advantages in the third plan which includes additional cleanings for gum treatments, white fillings for back teeth, and dental implants. Each member can pick a combination of four adult cleanings or gum treatments per plan year.
DD Services, Inc. (DDS)
DDS is a Preferred Provider Organization (PPO) who has provided administrative services for self-insured group dental plans for over 30 years. Utilization costs (claims paid) can be reduced significantly by using our PPO panel of dentists. The panel accepts fees that are 30-50% of ’usual & customary’ because of the number of patients referred through the dozens of DDS participating groups. Lower fees, in combination with peer review and very competitive administrative rates, will lower the cost of your dental plan without sacrificing quality or your choice of dentists.
EmblemHealth is a local, neighborhood health plan which has been providing health coverage to the New York City area and surrounding communities for over 75 years. Emblem Health offers a variety of commercial and government-sponsored health plans for large groups, small groups, individuals and families, with a broad network of doctors and hospitals throughout the tristate area.
Sele-Dent is a leading national dental PPO, and Third Party Administrator. With many years of experience, Sele Dent is able to provide the best dental products, and discount programs in the nation — this includes dental and prescription discount cards. Plans are available for individuals, families and groups of any size. Pricing for groups are able to be customized to provide further savings.
Fidelis Care provides health insurance coverage through Qualified Health Plans, Essential Plan, and Medicaid – available through the NY State of Health Marketplace and through the Medicare Advantage, Dual Advantage, and Managed Long Term Care programs. Fidelis Care is a Statewide health plan with a wide range of participating doctors and hospitals in their network. Coverage includes the dental benefits and services that patients need, like: regular checkups, preventive care, x-rays, and more.
Professional Benefit Administrators (PBA)
PBA has created and refined a long list of products and services to assist with achieving the goals of employee benefit programs. PBA offers proven, effective solutions that you can customize to fit you or your client’s needs. PBA has used state-of-the-art technology with our strategic partners to create an organization that can help provide the most affordable results for your health plan.
PPO Dental Insurance
PPO dental plans are the more common kinds of plans amongst families and individuals. This type of dental insurance provides in-network dentists for you but also allows for you to pick a dentist outside of the network. You do not need a referral in order to see a licensed dentist for dental service. You can switch your dentist whenever you choose want to without calling your insurance.
Typically, there is an annual deductible that must be paid before insurance can cover dental services. The insurance covers a portion of the cost while the patient covers the rest.
You are required to pay an annual deductible but the amount will depend on which insurance provider and which plan you have. A patient’s annual maximum also is dependent on which dental provider and plan you have purchased.
We also accept various out of network PPO insurance providers including Cigna, DC 37, 1199SEIU, GHI, HealthPlex, and Metlife.
For more information on your PPO insurance coverage with us, call or visit us in Brooklyn, NY today. We are on Ocean Avenue, and corner of Kings Highway, near the Brooklyn Public Library. Our second location is on Myrtle Avenue, and corner of Emerson Place, near the Brooklyn Navy Yard.
Disclaimer: This information is subject to change on behalf of the insurance company. We are providing this as an informal guide to help you determine which services at our office are covered by your insurance. For more detailed information please visit the insurance’s webpage or contact the customer service or member service number listed on most ID cards.
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