What is PPO Dental Plans
(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. Here is the basic coverage for most dental insurance companies :
100% for preventative care (exams, x-rays, basic cleanings 2 per year)
80% for basic care (fillings, root canal, deep cleaning)
50% on major treatment (crowns, bridges, partials, Implants *)
Annual maximums generally range from $1,000 to $3,000 per year.
What is HMO Dental Plans
Dental Health Maintenance Organization (DHMO) plans, also referred to as pre-paid plans, require you to choose one dentist or dental facility to coordinate all of your oral health needs. If you need to see a specialist, your primary care dentist will refer you; specialty care may require preauthorization.
A typical DHMO-type plan doesn't have any deductibles or maximums. Instead, when you receive a dental service, you pay a fixed dollar amount for the treatment (a "copayment"). Often, diagnostic and preventive services have no copayment, so you pay nothing for these services. However, generally if you visit a dentist outside of the network, you may be responsible for the entire bill. These plans can be a very affordable option for individuals and families.