What does “Preferred Provider” mean

| May 18, 2009

Preferred Provider is a term used by the Insurance Industry to make it sound like these doctors/dentist are “better” than others.  Makes it seem that perhaps your Insurance company has graded the dentist in some way to prefer them over all the other dentists in the area.

In reality, a “Preferred Provider” to a dental insurance company is a dentist that has agreed to take reduced fees in order to be on a list.  And remember that no dentist goes on a list to make less money.  It means they need more patients and they will reduce their fees to get them.

So, how do they make up for the reduced fees?  One way is double booking appointments so they can see more patients in the same day and make up for what they are reducing in thier fees.  What does double booking appointments mean to you?  A long wait in the reception area, in the dental chair, and being rushed through your appoinment just to start with.

Dental Insurance is different than Medical Insurance – In many ways, too many to put in the blog post.  But here are the highlights

  • 9 out of 10 medical doctors are on an Insurance preferred provider list
  • 2 out of 10 dentists are on an Insurance preferred provider list
  • Medical Insurance Lifetime maximum coverage per patient can be 1 million dollars
  • Dental Insurance Annual maximum coverage per patient ranges from $800 – $1500 per year.  That would be a lot of years before it reached a million.
  • Medical Insurance monthly premium fee is hundreds of dollars
  • Dental Insurance monthly premium fee is $10 for a family of 4

So when you decide to chose a dentist because your insurance provider has them on a list, think about this:   Did you spend more time chosing where you are going for lunch?