Insurance Information

At Oscar M. Peña, DDS, MSD, PC we make every effort to provide you with the finest care and the most convenient financial options. To accomplish this we work hand-in-hand with you to maximize your insurance reimbursement for covered procedures.
We accept and honor most dental insurance plans.
For more details, please ask one of our team members. We are well informed and up-to-date. We can be reached by phone at (520) 299-6662.

Insurance FAQ

What’s the difference between Indemnity, PPO, HMO, & Discount insurance plans?

Indemnity or Traditional Insurance reimburses members or dentists at the dentist’s UCR (Usual, Customary & Reasonable fee).  This allows the subscriber to go to any dental office without being limited to a panel.

PPO (Preferred Provider Organization) is the most common form of insurance.  They provide members with a list of participating dentists to choose from.  The dentists on this list have agreed to a lower fee schedule, which provides you with greater cost savings.  They also assist with insurance billing.  Most companies pay 50% on major treatment (crowns, bridges, partials), 80% for basic care (fillings), and up to 100% for preventative care (exams, x-rays, basic cleanings).  Annual maximums generally range from $1,000 to $2,000.

HMO, also known as capitated or prepaid insurance, was designed to provide members with basic care at the lowest rate.  Participating providers receive a monthly capitation check for patients assigned to the office.  This amount is only a few dollars and is intended to offset the administrative costs.  HMOs generally don’t pay for services rendered.  Fees are usually greatly reduced, but the patient is solely responsible for paying the doctor.

Discount Plans simply consist of a panel of dentists that have agreed to a reduced rate, with the subscriber being solely responsible for the entire portion.  There is no billing or annual maximums.

What’s a covered benefit?
Treatment that is recommended, is listed on the fee schedule, and accepted under the terms of your group’s plan.

What’s optional treatment?
Treatment that is either not listed on your fee schedule or more than the minimum to restore the tooth back to its original function.

Please call if you have any questions or concerns regarding your initial visit.

Please bring your insurance information with you to the consultation so that we can expedite reimbursement.