Dental Insurance – 4 Things That Should Be Covered

Forget your ABC’s. When you’re trying to find a good dental health insurance plan, you need to focus on other letters like PPO and HMO. But which one is right for you?

In order to answer that question, you have to understand all of the differences between an individual dental PPO and an HMO.

1. HMO’s require referrals

If, for example, your overbite is getting worse and you know that an orthodontist is going to have to fix it, you can’t just call up an orthodontist if you have an HMO. Instead, you will first have to schedule an appointment with your primary dentist, so that he can officially refer you to an orthodontist.

With an individual dental PPO, you don’t have to worry about this extra step. You can go to a specialist, on your own, anytime you feel that it’s necessary.

2. An individual dental PPO does not require having a primary dentist

When you have PPO dental plan insurance, you don’t have to officially list one dentist as your “primary dentist”. Instead, you can try out several different ones if you want. However, with an HMO dental health insurance plan, you are required to select a primary care dentist who will be responsible for managing all of your dental care needs.

3.A PPO dental health insurance plan doesn’t require you to stay in-network

Both PPO’s and HMO’s come with a list of approved providers that includes general dentists, specialists, and facilities. If you have an HMO dental health insurance plan, you are required to stick to this list; if you don’t, you won’t have any coverage.

PPO dental insurance is a little more forgiving, though. If you don’t stick to the approved provider list, you will wind up paying more out of pocket for the treatment and services that you get – but your insurance company will not cut you off completely.

With either type of dental plan insurance, it is best to stick to dentists and facilities that are in your network.

4. HMO dental insurance tends to be cheaper

Because an individual dental PPO plan comes with more freedom than an HMO, it also tends to cost a little more in the form of higher premiums, higher deductibles, and higher copays. In fact, most HMO dental insurance doesn’t even come with a deductible that you have to meet! Before you pick a dental insurance plan, you will have to decide if having that extra freedom is worth paying some extra money.

Comments are closed