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PPO vs HMO Dental Insurance — Which Is Better?

September 22, 2020

Filed under: Uncategorized — willowrundental @ 7:19 pm
PPO vs HMO question — types of dental insurance

Are you shopping for next year’s dental insurance? Perhaps you are dissatisfied with your current plan, or maybe this will be the first time that you have had dental insurance in a few years. One of the biggest decisions you must make is whether you want a PPO or HMO plan. In this article, we will define what these two types of dental insurance and help you assess which one might be a better fit for your circumstances.

What They Mean

PPO stands for Preferred Provider Organization. For PPO plans, an insurance company has contracts with a network of dentists who have agreed to charge certain fees for approved services. However, patients are allowed to use their benefits at any dentist, regardless of whether they are in their plan’s network.

HMO stands for Health Maintenance Organization. With an HMO plan, you select a primary care dentist that is in the insurance’s network, and unless you encounter an emergency or are referred to a specialist, you must rely on that dentist for all of your oral health needs.

Coverage and Fees

Most PPO and HMO plans allow you to attend routine preventive appointments — checkups and cleanings — while paying nothing out of pocket. However, with a PPO plan, you might have to pay a deductible before your insurance kicks in. HMO plans are usually without any deductible.

If you require a restorative treatment, you will have to pay a fee when you visit your dentist. With PPO plans, this fee is usually a coinsurance, which is a percentage of the total cost of your procedure. With an HMO plan, you must pay a copay, which is a predetermined, flat rate.

Annual Maximums

Most PPO plans come with an annual maximum, which is the highest dollar amount that the insurance provider will pay out for approved services within a calendar year. Usually, the maximum is somewhere in the neighborhood of $1,000. HMO plans typically do not enforce an annual maximum.

Is One Better than the Other?

The type of insurance that is best for you depends on your priorities. While HMO plans might cost less, they severely restrict your choice of dental care providers — which means that you might not get the high-quality, comfortable care that you deserve. While PPO plans may present more of an expense, they give you more control over how you manage your oral health.

Buying dental insurance presents a big decision. Before you make any commitments, you may want to call your dentist in Auburn to find out which types of insurance they accept. That could be a key factor in helping you find the right coverage!

Meet the Practice

Willow Run Dental Association has three talented dentists on-staff. They have decades of combined experience and pride themselves on providing top-quality care. They also understand that many patients have financial concerns, which is why they are happy to accept payment from most PPO insurance plans. To learn more about our practice and our policies, contact us at 207-783-0261.

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Willow Run Dental Association is a 42 North Dental Care, PLLC practice and is owned and operated by dentists Dr. Samuel Shames, DDM. and Dr. Ronald Weissman, DDM. Gentle Dental is supported by 42 North Dental, LLC, a dental support organization that provides non-clinical administrative and business support services to the practice. 42 North Dental, LLC does not own or operate the dental practice or employ dentists to provide dental services. Find more information about 42NorthDental, LLC and the dental practices it supports at 42northdental.com.