You are free to choose any dentist for treatment, but it is to your advantage to choose an In-Network provider. This is because contracted providers have agreed to a pre-negotiated amount per covered procedure. The only amount chargeable to the member by an In-Network provider is the actual member percentage (based on the Plan), non-covered services, upgraded services, and any amount over the annual maximum of the pre-negotiated amount.

Out-of-Network providers have no agreement, so the amount chargeable to the member can be any amount over the percentage payable by the Plan. Plan payment is based on the PPO pre-negotiated allowable amounts.

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