Generally, dental insurance works like medical insurance with majority of such plans having a network of providers who offer services at a negotiated discounted rate. The type of dental insurance you have will determine where you can get dental service and how much your out-of-pocket costs will be.
The two most common types of dental insurance are:
Dental Health Maintenance Organization (DHMO)
In this plan, all dental care is provided by the dental professionals who are part of the plan’s network. When you become a member of a DHMO, you choose your primary dental service provider who will coordinate your care and, when necessary, will refer you to other specialists, like an oral surgeon.
Whenever you need dental service, your first visit should be with your primary dentist. One of the advantages of joining a DHMO is the convenience of not having to fill out a ton of paperwork. In terms of costs, you just have to pay a specific co-payment amount and the deductible, if any, upon your visit to a network-affiliated dentist.
Usually, DHMOs have lower out-of-pocket costs than other types of dental insurance as long as you choose a provider within the network. If it’s not an emergency and you decide to get care from an out-of-network provider, you will have to shoulder the full cost of the service.
Dental Preferred Provider Organizations (DPPO)
In this plan, you can choose to get care from dental providers whether or not they are part of the plan’s network. You also don’t have to choose a primary care provider or request for referrals if you need to see a specialist. However, receiving care from an out-of-network provider would still cost you more than going to an affiliated dentist.
The difference in this case would be that you do not have to pay the full cost of the service, just a larger percentage of the cost. Also, there will be minimal paperwork if you choose to stay within the plan’s network of providers since the dentist’s office will take care of sending the claims to your insurer.
If you choose an out-of network provider, you will need to pay for some of the cost and then submit the paperwork for reimbursement to your insurer.
Consult with a Local Dentist
To know more about the different types of dental insurance, speak with your dentist. Looking for a reputable dentist for you and/or your family? That’s where TalkLocal can help. Find the best dentists in your area with our free service. Try TalkLocal now!
Tags: Types of Dental Insurance
