Dental Helps Learning Center
Part 1: Plan Types
PPO (Preferred Provider Organization) Dental Plans
PPO dental plans are generally the best dental insurance plans available, offering a compromise between lower costs and choosing the dentist you wish to visit. Choosing PPO dental coverage generally results in the lowest expenses when you visit a PPO dentist, but your dental treatments will still be covered according to your plan agreement should you choose or need to visit a dentist outside the network. There are huge networks of PPO dentists across the country, so finding one to suit you is easy, and many participating dental practices will bill your insurance directly for your care and treatments, so you pay only your copayment, rather than paying the full amount and waiting for reimbursement. PPO dental coverage usually covers varying levels of treatments at different rates - for example you may only pay 20% of the full bill for preventative treatments, but 50% for more specialized treatment - but they generally offer the most comprehensive coverage for your dental care.
HMO (Health Maintenance Organization) Dental Plans
Often referred to as DHMO or pre-paid plans, HMO dental plans are a common choice for dental insurance in the USA. They generally require you to choose one specific dentist to take care of all your dental health needs, or those of your family. When specialist care is required for your teeth or gums, your dentist may refer you to another office, but in many cases the specialty care may require preauthorization from your HMO. While many basic diagnostic or preventative treatments are entirely covered and require no copayment at all, HMOs rarely cover treatment by a dentist other than your regular dental network. This means that if you require specialist care, or have a dental emergency while away from home, you can be on the hook for the entire bill, which can be an expensive and unpleasant surprise on top of the need for dental care.
Discount (Or Reduced-Fee-For Service) Dental Plans
While many people refer to these service plans as dental plans, they are not, in fact, insurance at all. Discount dental plans require you to pay a monthly or annual fee and simply offer access to dental services and treatments at a reduced rate when you visit participating dentists. While there are no limits, deductibles or insurance forms to fill out, this is simply because you do not actually have insurance. Discount plans are only valid at your participating dentist, and often charge patients for a greater portion of their dental treatments than PPOs or HMOs. Specialist and emergency treatment are generally not available on discount dental plans.
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