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Which Is The Best Dental Insurance?

APR 14

You've probably heard of different types of dental insurance, but do you know what the differences are and which one is best for you? The main purpose of all dental insurance is to make dental care more affordable. Without insurance, an emergency root canal or tooth extraction can set you back thousands of dollars.

The function of dental insurance is like medical insurance in many ways, except dental insurance is not required by law, and dentists don't require that you have insurance to be seen if, for instance, you prefer to pay directly with cash. There are many options when it comes to dental plans, and they vary in what they cover and how much they cost.

There are two main types of plans: Preferred Provider Organization (PPO) and Health Maintenance Organization (HMO). You've probably heard those acronyms before, PPO and HMO, and at least now you know what they stand for. Let's look at what each one is and then compare the differences so that you can decide which one is best for you.

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What is a PPO dental plan?
Preferred Provider Organization or PPO dental plans are dental insurance plans that provide coverage for preventive treatments, dental surgeries, and other dental emergencies. They usually cover both adults and kids in a family under one plan. These dental plans are usually accepted by most dentists, making it convenient to get services without having to change insurance providers.

PPO dental plans provide dental coverage for either an annual fee or a per visit fee. PPO dental plans can be beneficial because they usually give discounts or waive deductibles and copayments for checkups and cleanings. Why is this? Because they want to encourage and reward their clients for getting preventive care so that they can avoid more costly procedures down the road. And, for procedures that do require a partial payment after insurance coverage, you will be able to receive those dental services at prices lower than the usual out-of-pocket cost of dental procedures.

However, PPO dental plans do sometimes limit your dental coverage options because they might not pay for elective or cosmetic dental services that aren't considered necessary to one's oral health, such as teeth whitening. You should review which dental procedures and services a dental plan does and does not cover before signing up for one.

What is a HMO dental plan?
A Health Maintenance Organization or HMO are government-supported programs that provide dental care under certain conditions. An HMO plan can cover an individual or dependent members within a family. HMO programs work with a limited network of dental providers in order to reduce patient costs. In other words, members have lower out-of-pocket costs because they receive the majority of their dental care from 'in network' dental care providers. These predetermined dental care dental providers and dentist's offices can then offer reduced rates for services to attract more patients. With HMOs, there may be waiting periods, copay or coinsurance fees, and yearly maximums. In addition, some dental treatments you need must be pre-approved, such as cosmetic dentistry and dental implants, before you go to a dental clinic, so it's important to carefully review the dental benefits when choosing an HMO dental insurance plan.

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Which is better PPO or HMO dental insurance?
This is a good question and one that dental insurance customers should consider before they select a plan or a dentist, especially if their current or prospective dental care provider participates in both types of plans. So, which one is best? Well, that depends on your budget, your employer (in some cases), and your preferences.

PPO dental insurance works off of a fee-for-service model, which means you can go see any dental professional or specialist without restrictions and be partially covered through your dental insurance. Depending on what you're having done, your dental insurance company pays all or a portion of the bill.

One of the main benefits of PPO dental insurance is it allows you to choose which dental professional or specialist you use. You can see both in-network and out-of-network dentists. The insurance company will cover more of the costs if you seek treatment with in-network dental professionals, but if you prefer a specific out-of-network dentist and are willing to pay a little more out of pocket, you are not limited. So, with a PPO, you have more options and flexibility in the market, but you may pay more for your services.

In contrast, HMO dental insurance works only within a set dental network, meaning there are no out-of-network coverage options. In an effort to reduce your costs, dental care options are limited to those dental professionals and specialists on the approved in-network list. You will only be able to be seen by a dental professional or specialist outside of the network when you receive a referral from your primary dental provider first.

HMO dental insurance is generally more affordable, but you have less freedom in choosing where you go for treatment because you are restricted to dental professionals and specialists within the network.

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