Today, businesses, families, and individuals have multiple choices to reduce out-of-pocket dental care costs. These options include PPO and DHMO dental insurance plans. You may also consider dental savings plans — an affordable alternative to traditional dental insurance plans.
Let’s take a closer look at dental insurance plans and dental savings plans.
What are the Main Differences Between PPO and DHMO Dental Insurance Plans?
Choosing between a PPO and DHMO insurance plan can sometimes lead to confusion. To help you better understand these choices, we’ve broken down the key differences between DHMO and PPO plans:
What is PPO Dental Insurance?
- It offers out-of-network coverage, meaning you can choose any dentist you want.
- It’s more flexible when it comes to specialists and treatments beyond preventive care.
- There’s typically higher monthly premiums due to offering both in-network and out-of-network coverage. However, many PPO plans have minimal or no co-pays.
- Many PPO plans have an annual maximum limit — the highest amount an insurer will pay towards your dental treatment in a calendar year.
What is DHMO Insurance?
- It doesn’t offer out-of-network coverage. If you choose a dentist out of network, you will likely pay out of pocket.
- It’s more restrictive regarding specialists and treatments other than preventive care.
- There’s usually lower monthly premiums and co-pays when you take advantage of the services.
- There’s rarely an annual maximum limit.
PPO Dental Insurance: Understanding the Benefits and Drawbacks
If you’re interested in a PPO plan, it’s essential to understand both its benefits and drawbacks.
Benefits
Dental PPO insurance plans — also known as dental preferred provider organizations or DPPOs — are a popular dental insurance option due to their flexibility in allowing insured members to choose dentists and dental specialists. Typically, PPO dental insurance plans are said to offer better service and have fewer limitations than HMO dental insurance plans, but the premiums are usually more costly. Businesses often use PPO dental insurance plans to provide their employees with valuable dental benefits. PPO dental insurance plans are used by individuals and families as well.
Dental preferred provider organizations are managed care organizations with a network of dentists under contract with a dental insurance carrier. This network of dentists provides dental PPO insurance plan members with special rates on dental care. The rates are usually lower if the insured member selects a primary dentist or dental specialist from the dental PPO network. However, the insured individual is free to choose a dental care provider outside the established network.
Drawbacks
Despite this flexibility, PPO dental insurance plans have some limitations as well. In addition to the higher premiums usually associated with dental PPOs compared to other dental savings plans, you typically have to wait to receive reimbursements. If you’re insured with a dental PPO insurance plan, you’re responsible for paying the deductible before receiving any reimbursement.
In addition, you have to make a co-payment to the dentist since most dental PPO insurance plans only cover a portion of the dentist’s fee. Many people join PPO dental insurance plans because this type gives them more freedom when choosing a dentist or dental specialist.
DHMO Dental Insurance: Understanding the Benefits and Drawbacks
DHMO dental insurance plans are another option to consider. Here are the benefits and drawbacks.
Benefits
DHMO dental insurance plans — also known as dental health maintenance organizations or DHMOs — are usually much cheaper than PPO dental insurance plans. DHMO plans have networks of dentists under contract with the dental insurance company that offer dental services to insured members at predetermined rates. Businesses usually provide DHMO dental insurance plans to their employees, but individuals and families also use them.
Drawbacks
One of the main advantages of DHMO dental insurance plans is that they usually have lower premiums than the other dental insurance options. However, DHMO plans have been known to impose strict restrictions on insured members. For example, the DHMO won’t provide reimbursement if you see a dentist that’s not in their network. If you have a DHMO plan, you must select a primary dentist from a pre-approved list. Plus, all referrals to dental specialists must be provided by the primary dentist.
PPO vs. DHMO: What’s the Best Option For You?
Choosing between a PPO and DHMO dental insurance plan depends on your needs, budget, and lifestyle. If you prefer flexibility and freedom in choosing your dentist or specialist, a PPO plan may be better for you. On the other hand, if you’re on a budget and don’t mind picking from a select group of dentists and specialists, a DHMO plan might be more suitable for you. However, another option you can use with or without dental insurance is a dental savings plan.
Dental savings plans, although not a dental insurance product, provide individuals, families, businesses, and other groups with affordable access to dental care. Dental savings plans provide plan members with set discounts on most dental procedures from a nationwide network of more than 140,000 dentists and specialists. Most of the plans you’ll find on DentalPlans.com offer savings of 10-60% at the dentist, and while dental insurance can have annual maximums, deductibles and co-pays, dental savings plans do not.
To find out more about dental savings plans, you can call us at 1-833-735-0399. We can answer any questions about how a dental savings plan can help provide affordable access to dental care.
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