HMO vs PPO Dental Insurance Plans

hmo vs ppo dental

Should I get a PPO or HMO dental plan?

If you are currently in the look for a dental plan, you may be curious in the differences between HMO and PPO dental insurance policies.

There are plenty of insurance companies out there offering a wide variety of plans, using complicated language, making customers feel overwhelmed.

Dr. Debbie Luis

Dr. Debbie Luis

Mother - General Dentist - Blogger

And let me tell you that you’re not alone! but don’t you worry, we’re here to help; this article will break down the important differences between these two kinds of dental plans so you can make an informed decision.

In addition to that, we will provide you some advice on how to choose between hmo and ppo dental insurance policy so it suits your needs. So read on if you’re attempting to choose which plan is ideal for you.

What is an HMO Dental Insurance Plan?

A Dental Health Maintenance Organization or HMO plan is designed to cover basic dental services at a moderate monthly premium. Members have to select a primary dentist and need a referral to visit specialists. Coverage is only guaranteed if they use an in-network provider.

What is an HMO Dental Insurance Plan?

A Preferred Provider Organization or PPO dental plan usually has a much bigger provider network and offers the flexibility of visiting any provider or specialist even if they are out-of-network without a referral. Although visiting an in-network provider offers maximized coverage.

What are the differences between HMO and PPO dental insurance plans?

There are a few key differences between HMO and PPO dental insurance plans:


The monthly premiums for HMO plans are often less expensive, though they cover a smaller range of services. In general, PPO plans have higher monthly premiums, but they cover a wider range of medical services.

Choice of dentist

Members of HMO plans are often required to visit dentists who are part of the plan’s dental network. In contrast members of PPO plans are free to see any dentist they like, but they may incur additional costs if they see a dentist who is not part of their plan’s network.

If you want to see if your dentist is part of our 500,000+ network of dental providers click here.

Out-of-pocket costs

Members of HHMO dental plans often have lower out-of-pocket expenditures than members of other types of dental insurance. In the other hand with PPO dental plans are expected to pay a larger percentage of their medical expenses out of pocket on average.

Still scratching your head? Relax, choosing the right dental plan depends on your needs and budget. If you’re looking for comprehensive coverage a PPO dental insurance plan may be good whereas if you want lower monthly premiums you may want a HMO dental insurance plan.

But to be able to choose a plan that fits you you should ask yourself the following questions:

What are the benefits of each type of dental insurance plan?

HMO dental insurance plans offer several benefits, including:

– Lower monthly premiums
– A set number of covered services each year
– The ability to see dentists in a specific network

PPO dental insurance plans offer several benefits, including:

– Higher monthly premiums
– More comprehensive coverage
– The ability to see any dentist you choose (but you may pay more if you see a dentist out of the network)

What are the disadvantages of each type of dental insurance plan?

HMO dental insurance plans have a few disadvantages, including:

– Fewer covered services than PPO plans
– The need to see dentists in a specific network

PPO dental insurance plans have a few disadvantages, including:

– Higher monthly premiums than HMO plans
– More out-of-pocket costs for members

What dental services are covered by an HMO vs a PPO?

HMOs and PPOs may cover the following whether you purchase a dental plan independently via an individual insurance carrier, or through your employer:

Preventive dental care

Typically covered at 100% both by HMO and PPO dental plans. Fluoride treatments and sealants are included in preventive dental care. There may be age restrictions and limitations on the number of each you may have every plan year.

Basic Services

Typically, HMO plans will charge a set rate for these sorts of dental procedures but might have limitations like the number of visits allowed. PPO plans usually cover a percentage of the total price but must first satisfy your deductible.

Major Procedures

In general PPO dental plans offer much better coverage for major services like crowns, fillings, root canals bridges, etc although they also come with higher out-of-pocket expenses than HMO dental plans. 

Before enrolling in a dental plan, you should carefully review the coverage specifics, including restrictions, exclusions, and any waiting periods.

Click here if you want to see the benefit chart of our dental plans. 


Dental plans such as HMOs and PPOs each come with their own own set of benefits as well as drawbacks. There is no dental insurance plan that is suitable for everyone; rather, the dental insurance policy that is ideal for you will be determined by your specific requirements as well as your financial situation.

If you’re struggling to find an affordable dental plan, SHD offers great options for individualsfamilies and seniors. Call now to get a free Quote!

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