HMO the Affordable dental Insurance plan
Hi I have been looking on line for dental insurnce for some time now. I am in no real hurry to make up my mine about one plan over the other. However it seems to me if you want something that is affordable then the HMOs plans I seen offer you their plans between $6 – $20 a month.
Where as PPOs are form $30 – $50. My question is why is there such a big price difference? Are HMOs plan cheap because the do not have good coverages? I look and the coverages and they sometimes seem better then a few PPOs plans I come across. Is there something I am missing here?
Friday, Sep. 17th 2010 10:54 AM at 10:54 am
The key is in understanding how PPO and HMO work.
HMO refers to a dental health maintenance organization
These insurance plans, also known as “capitation plans,” operate like their medical HMO cousins. This type of dental plan provides a comprehensive dental care to enrolled patients through designated provider office.
A Dental Health Maintenance Organization (DHMO) is a common example of a capitation plan. The individual and family dentist is paid on a per capita (per person) basis rather than for actual treatment provided.
Participating individual and family dental offices receive a fixes monthly fee based on the number of patients assigned to the office. For that the dentist in the network have agree to the pricing fee schedule for the dental services as listed under the HMO plan details. When you can control cost your cost is normally less.
Preferred Provider Organizations
Another true dental insurance plan, a Preferred provider organizations ( PPO) falls somewhere between an indemnity plan and a dental HMO. This plan allows a particular group of patients to receive dental care from a defined panel of individual dental insurance dentists. This type could be used to provide dental gap insurance.
The participating individual or family office agrees to charge less than usual fees to this specific patient base, providing savings for the plan purchaser. If the patient chooses to see one who is not designated as a “preferred provider,” that patient may be required to pay a greater share of the fee-for-service. PPO’s may have waiting periods and annual dollar max limitations and are normally more costly then the HMOs
Friday, Sep. 17th 2010 10:58 AM at 10:58 am
I do not think that HMO’s is any better or worse then PPO’s. What make a dental insurance plan better then the next is how it will fix your personal dental needs.
If you find that an HMO work best for your needs and there is a dentist you can go to under the plan why not get the less costly plan for yourself.
However if you feel a PPO is better for your dental needs then the extra cost does not really become a factor.
Read though each plan terms and conditions in order to decide what is best for you.
Friday, Sep. 17th 2010 11:07 AM at 11:07 am
I think HMOs are better to me a dentist is a dentist and the bottom line is my out of pocket cost.