A passive PPO Plan (allowing almost the same level of benefits at both network and non-network provider offices) is the most common type of benefit chosen by Premier Access customers. Members can maximize their dental benefits by receiving services at a discounted rate from contracted PPO providers. Premier Access has over 6,000 PPO Providers in California alone and members can access an additional 20,000 PPO Providers outside of California. Under this category of benefits, the member also has the flexibility to receive care from an out of network provider. We will reimburse an out-of-network provider based on the Usual, Customary & Reasonable Rates of that area.

PPO Plus Plan

A PPO Plus plan is structured similar to a passive PPO plan, in that members receive services at a discounted rate from contracted providers, while still having the flexibility to access care from an out-of-network provider. However, out-of-network providers are reimbursed based on the same discounted fee schedule as PPO providers. This arrangement strongly encourages the members use of a PPO provider versus an out-of-network provider to maximize their dental benefits.

For more information about this plan, please Contact Us.