Question: How can you know what your true cost is for dental insurance plans that say they pay out by a percentage but only up to UCR.  I asking because right now I have a PPO plan offer to me though my job.

However whenever I go to the dentist to use my dental PPO plan I always get hit with an additional UCR fee cost.  I am not sure if I just have a bad plan where I should find my own dental plan that offers better coverages or if I being taken by the dentist.  How does one figure this out.

Answer:  Here are a few things to think over when dealing with dental insurance plans that have UCR fees.

1) Are you going to a plan provider of your PPO?  Generally when using the PPO’s plan providers you reduce your risk of having UCR fees.

2) Are you seeing a dentist that is in your rated area?  If you live in a lower cost area but see a dentist in a higher cost area (plan provider or not) you increase your risk of UCR fees because UCR fee are based on your home zip not the zip of the dentist you are seeing.

3) Remember if you do not want to have any surprise UCR fees after the fact make sure to have your dentist file a quote only for your services to your insurance company so that they can then advise you of what they would pay out prior to you having or starting the dental service.  Then you decide if the price is something you can afford at the time or not.

4) If you feel that even with your PPO insurance though work is still too costly or you would like a more straight forward cost statement for services you at that point may want to review an HMO dental insurance where all their dental services that are covered are listed on a fee schedule that clearly shows the cost for each dental service offered under the plan leaving out the risk of additional charges due to any UCR fees.