Are There PPO Plans that do not Pay Out of Network Benefits?

In this episode, Gary and Naren address a common question: Are there PPO plans that do not offer out-of-network benefits? They clarify that the majority of PPO plans are open panel plans, where patients can choose any provider, and the insurance pays benefits either to the provider or the patient. However, there is a tiny minority of closed panel plans, which only provide benefits if the patient sees an in-network provider. While closed panel plans are rare, they exist, and Gary shares insights on navigating such situations. He also emphasizes the importance of attracting patients through qualitative factors like online presence and reputation rather than relying solely on insurance provider lists.

• 00:00:50 – Introduction to the episode
• 00:01:29 – Quick announcement about the upcoming Master Class
• 00:04:20 – Jumps into the topic
• 00:05:00 –  Two types of PPO plans
• 00:09:30 – Shifting to an in-house membership plan 
• 00:10:10 – Purchasing dental insurance 
• 00:12:50 – Percentage of  closed plans
• 00:14:00 – Replacing Delta with Google
• 00:16:00 – Google reviews

Learn more about the Masterclass

Reviewed by

Naren Arulrajah

CEO & Founder, Ekwa Marketing

Naren Arulrajah is the CEO and Founder of Ekwa Marketing, a 300-person dental marketing agency that has helped hundreds of practices grow through SEO, reputation management, and digital strategy. A published author of three books on dental marketing, contributor to Dentistry IQ, co-host of the Thriving Dentist Show and the Less Insurance Dependence Podcast, and a member of the Academy of Dental Management Consultants. He has spent 19 years focused exclusively on helping dental practices succeed online.