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Types of Dental Insurance

Nov 20, 2013

We are kicking off our blog posts with some posts about dental insurance. We want to make sure our current patients and our future patients have all the tools they need to make their insurance work for them.


To start with, your insurance plan is a contract between your employer and the insurance company (or if you have your own insurance, between you and the insurance company). So it is best to consult your coverage book or contact your insurance company if you have any questions about your specific plan. These sources are your best resources for any questions you have regarding your plan. This series of posts is just to give you hints and tips to use while navigating through your insurance plan.


 Types of Dental Insurance

There are several different types of dental insurance: HMO/DMO, PPO, and Indemnity or Traditional. It’s best to know what type of insurance you have prior to your dental visit as this will affect your coverage.


  • HMOs/DMOs – short for Health or Dental Maintenance Organization – restrict their patients to choosing their provider from a designated list of providers. Although this is the least expensive option for dental insurance, you get the least amount of choice. Dental providers who contract with HMOs are paid a small dollar amount per member per month regardless of services rendered.

 

  • PPOs – short for Preferred Provider Organization – allow you more freedom as you can choose which provider you would like to see. They provide incentives to the patients for choosing an in-network provider in the form of discounted services. The patient can still choose an out-of-network provider, but they will have to pay the difference between the insurance company’s discounted fee and the dentist’s fee.

 

  • Indemnity or Traditional dental plans offer the most flexibility for patients, as they can go to whichever provider they choose. In this case the insurance company pays a certain percent for a service and the patient is responsible for the remainder.

When choosing your dental insurance plan it is best to keep in mind how much choice you want, not only in your dental provider but also in the quality of service that you would like to receive. Choosing an Indemnity plan may cost more, but it will also result in higher quality dental care.


Good oral health starts with you. Make sure you bring together the best team possible including your provider and your insurance company. For our current patients we work hard to be the rock-star member of your team. And for our future patients, we look forward to becoming a stand-out member of your team.

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