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If you have Guardian Dental Insurance. Please answer my Question!?

I have to choose between Guardian Dental PPO or Guardian Dental MDG which is like the HMO. Any advice or reccomendations? The difference is that PPO has almost everything covered up to $1000 and has a larger list of dentists. HMO has very very discounted prices and no limit, less dentists.

Public Comments

1. The difference between a PPO plan and an HMO-type plan is how your claims are paid. If you choose the PPO plan and see a dentist who is not on the preferred provider list, your insurance will still pay their percentage (usually 50%-80% for most procedures), but you will probably have a higher out-of-pocket expense. The insurance is paying their percentage of the fee that THEY allow for a procedure, but your dentist's fee may be higher. In this case, you are responsible for the entire difference, up to your dentist's fee. If you see a dentist who is on the preferred provider list, you would be responsible for the 20% (or other amount) your insurance does not cover, but nothing extra, as the dentist has a contract with the insurance company that dictates what fees he/she can charge. In an HMO-type plan, you must see a dentist on the insurance list in order to get any insurance benefit at all. If you see a dentist who is not on the insurance list, your insurance company will pay nothing. This is a very general explanation. Every insurance policy is different, and financial policies will vary by dentist. Call your dentist and talk to the insurance coordinator for help with your exact situation.