If you are contemplating a dental plan, then you would have to compare the difference between HMO and PPO dental policies. HMO is health maintenance organization and is often referred to as DHMO or dental health maintenance organization. PPO is preferred provider organization and is often referred to as DPPO or dental preferred provider organization plan. Let us study the difference between HMO and PPO dental plans.
Difference Between HMO and PPO Dental
• HMO plans usually have the most reasonable premiums. They are affordable dental insurance plans. PPO plans are almost always more expensive. There can be exceptions but very rarely.
• HMO dental plan requires you to select a primary dentist who is assigned for the first response and care when you need. You can change from one dentist to another as your primary choice once a month. There are certain exceptions in this regard as well. A few HMO plans will allow you to have a network of dentists instead of just one primary dentist. PPO doesn’t require you to choose any primary dentist. You have the liberty to choose any dentist and you can also change from one dentist to another without informing your insurer. HMO requires timely intimation and only when they make the changes at their end will you get your name on the revised roster.
• HMO dental plans would offer you coverage only when you visit a dentist or provider that has its services covered in a network. PPO plans will allow you to get coverage regardless of the dentist being in the network or out of it. However, the plans that offer coverage for out of network dentists will cost more.
• With HMO plans, there is a copayment or specific fee on the schedule of benefits which will clearly state which services are covered. You would also get to see how much you must pay for different procedures. PPO plans require you to pay coinsurance. Your insurer will pay a portion of the costs and you would pay the rest. The costs of dental services are capped to a dollar till which you would be covered. These are applicable to dentists in the network. For dentists out of the network, the coinsurance is much more.
• HMO dental claims are very easy to file. In most cases, the network dentist will do the needful. PPO claims are also easy to file. Network providers will often do it for you. If you opt for a dentist out of network, then you have to file it yourself.
