Go to an out-of-network good dentist, or in-network dental factory?
Im assuming you are talking about a PPO plan with Delta, because if you have a Deltacare HMO-type plan, I don’t believe you would get any benefits for going out-of-network. A PPO plan will pay, but at a lower rate for out-of network. Also, you can find a lot of good dentists in network, without going to a Doc in the Box clinic. Those generally are for the HMO type plans, and they do tend to be impersonal, they have to see several patients a day and spend as little time with them as possible to make money. And they have a huge incentive to do as much work as they can, whether or not it’s necessary. As far as the insurance company goes, they have their bottom line to look out for. They have their fee schedules which are below what the dentist charges, which isn’t to say that the dentist is overcharging. The insurance company wants to be able to sell your employer a plan which purports to pay 80% of fillings, which they think is great. But it only means the insurance company will pay 80%
