Dental Insurance Plans
HMO vs. PPO
There are several differences between HMO and PPO California dental insurance plans. While both can provide affordable dental insurance, HMO plans make it more difficult for patients to seek dentists outside a network. While PPO plans often allow patients to select dentists outside their network, many HMO plans do not. They are completely closed, meaning that you cannot accept financial penalties and see a non-network dentist when you need to.
The most serious difference between HMO and PPO dental insurance, however, has to do with the way that dentists are paid. In a PPO dental insurance plan, dentists who are part of a network agree to lower costs for patients covered by a certain insurance provider, in exchange for the referrals from the insurance company that bring them more business. However, dentists get paid in full for the services they provide. With an HMO dental plan, however, dentists are paid set fees. In some cases, this can mean that the less treatment a dentist provides, the more profitable the arrangement is.
In extreme cases, patients have complained that dentists have made it difficult to get the correct services through an HMO plan. Even in the best circumstances, since dentists prefer PPO dental insurance plans, many more join PPO networks. If you need immediate coverage however you typically want to enroll in an HMO due to there being less waiting periods and no benefit maximums.
