If you have a PPO dental plan, in most cases you can see an out-of-network dentist and your plan still pays part of the treatment. What changes is how much you pay. At PureSmile we check your plan for free before your visit and tell you, in writing, what it covers and what you'd owe.
An in-network dentist has a contract with your insurance company and agrees to its negotiated fees. An out-of-network dentist doesn't have that contract. PPO plans usually cover both kinds of dentists; HMO (DHMO) plans usually cover only dentists in their network.
It depends on your plan. Typically, your plan pays a percentage of a reference fee (for example, 100% of cleanings and checkups, 80% of fillings and 50% of crowns) and you pay the difference up to the clinic's price. That's why we give you the numbers before we start.
Many PPO plans from Delta Dental, MetLife, Cigna, Aetna, Guardian, United Concordia and others. Some PPO-type Medicare Advantage plans also have an out-of-network benefit. HMO or DHMO plans usually don't. The only way to know is to check your plan, and we do that for free.
More detail on each insurer on our dental insurance in Kendall page.
You may pay somewhat more; it depends on your plan and the treatment. We give you the numbers before we start so you can decide.
If your plan allows it and you sign the authorization, we bill your insurance directly and you pay only your share.
Yes. What your plan pays out of network comes out of the same annual maximum.
It usually doesn't cover out-of-network care. We give you a set price and financing options, and we'll let you know if that changes.
In most plans the annual maximum resets on January 1. If you have 2026 benefits left, it makes sense to use them before December 31.
Call (305) 787-3642 or leave your details and we'll check your plan for free. We open November 1 in Kendall.
