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.
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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.
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.
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.
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.
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.
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:
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)
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
HMOs and PPOs may cover the following whether you purchase a dental plan independently via an individual insurance carrier, or through your employer:
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.
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.
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 individuals, families and seniors. Call now to get a free Quote!
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Copyright by Smart Health Dental, LLC. All rights reserved. 2021.
Smart Health Dental is a national dental plan that is dedicated to providing you with the best service in the industry. We are committed to developing quality dental products that provide consumers with the best value and choices in the insurance industry.
The Smart Health Dental PPO insurance policy is underwritten by Renaissance Life & Health Insurance Company of America, Indianapolis, IN, and in New York by Renaissance Life & Health Insurance Company of New York, Binghamton, NY. Products and services referred to may not be available in all states and jurisdictions. There is no ownership affiliation between Renaissance and Smart Health Dental. For complete coverage details, please refer to the certificate of insurance.
Membership in Communicating for America, Inc. (CA) is required to enroll for coverage under the Smart Health Dental PPO insurance policy offered. CA membership provides non-insurance discounts like prescription drug discounts and a vision discount program. CA will communicate member information to you via email or by directing you to their website. Should an individual decide to enroll in the dental insurance policy, he or she will be prompted during the enrollment process to confirm acceptance of membership in CA.
*Certain restrictions apply; please call or email us for full details.
1Renaissance Partner Network Data 2016
DISCLOSURE: SHD Non-Insurance Discount Plan is NOT INSURANCE, nor is it a replacement for insurance. It is a discount program and does not meet the requirements of the Affordable Care Act (ACA). You must pay for services at the time they are rendered. If you receive services at a participating provider you will receive a discount on those services. It is not a Part D prescription drug plan. Neither Smart Health Dental nor Access One Consumer Health, Inc. will pay any fees to providers. You may request a refund within 30 days of receipt of your ID card and all monthly fees paid for your Smart Health Dental Discount program, excluding the one-time non-refundable processing fee, will be refunded (nominal fee for MD residents is $5, LA residents is $30, and TN residents will be refunded processing fee). If you cancel after thirty days for any reason other than nonpayment, the program will make a pro-rata reimbursement of all periodic charges. If you have a complaint regarding the program you may contact Access One Consumer Health 84 Villa Rd. Greenville SC 29615 or call (877) 346-4904. If you remain dissatisfied with the response you may contact your state insurance department. This program is not available in AK, AR, MT, RI, TN, UT, VT or WA.
The Smart Health Dental Discount Program provides access to the Aetna Dental Access® network, which is administered by Aetna Life Insurance Company (ALIC). ALIC does not offer or administer the Smart Health Dental Discount Program, and is not an affiliate, agent or principal of Smart Health Dental Discount Program. Dental providers are independent contractors and not employees or agents of ALIC. ALIC does not provide dental care and is not responsible for outcomes.
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