Dental PPOs and HMOs

Managed care dental plans are those that integrate the financing and delivery of dental care to covered individuals through arrangements with selected providers that furnish dental services to members.

Two of the most common managed-care plans are preferred provider organizations (PPOs) and dental health maintenance organizations (DHMOs).

Managed-care plans that incorporate indemnity plans are referred to as preferred provider organizations (PPOs). This type of plan is a regular indemnity insurance with a network of dentists under contract with the insurance company to provide specific dental services at a set fee rate. Parties insured through a PPO may incur higher out-of-pocket expenses if they visit a non-contracted dentist.

Another type of managed care plan is the dental health maintenance organization (DHMO), which allows a plan participant to receive certain services from contracted dentists at no or reduced costs. Because these plans do not reimburse the dentist or insured for individual services, the insured party must receive treatment through a contracted dentist to receive a benefit.

The primary advantage of the PPO and DHMO is that the cost of dental care is significantly lower for a participant than a non-participant. PPOs and DHMOs can also be cost effective for certain individuals with families because these plans typically have a larger participant pool that may offer less expensive rates for these people than other options.

For many Americans, dental insurance is an important part of their overall financial planning and well being. Knowing that their overall health, in general, and their dental health, in particular, are covered may help keep an insured's mind at ease

 

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