DHMO + DPPO: What’s the difference?
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Dental insurance allows you to save money on dental procedures and helps you maintain good oral health. However, with different plans available it can be overwhelming. Say you've narrowed down your choices to a dental HMO or dental PPO plan. What's the difference between these two types of dental plans? To help, here are seven differences between DHMO and DPPO dental plans that will allow you to confidently pick the plan that's right for you and your family.
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| DHMO | DPPO | |
|---|---|---|
Premium cost | Premiums on a DHMO plan typically are the least expensive of all the dental insurance plans. | The premiums for a dental PPO plan tend to be more expensive than a DHMO plan. |
Primary care dentist | Often, with a DHMO, you must select and be assigned to a primary care dentist. You can switch dentists once a month by calling your insurance company. Transfers are usually effective the next month. | You don’t have to be assigned to a primary care dentist but have the freedom to visit any dentist. As far as transfers, you can switch dentists at any time without having to call the insurance company or wait for your name to appear on an office roster. |
Provider access | You are only eligible for coverage if you visit an in-network provider for covered services. | With a DPPO plan, you receive coverage whether you visit an in-network or out-of-network dentist. However, you save more when you use an in-network provider. |
Payment | You pay the specific fee (copayment) listed on your Schedule of Benefits to the dentist for covered services. A Schedule of Benefits is a document that lists all the procedures your plan covers and what you pay for each procedure. | An in-network dentist has made an agreement with your insurance company to charge up to a certain dollar amount for covered services. When you use an out-of-network dentist, your coinsurance is higher because that dentist does not have an agreement with the insurance company and will therefore charge their usual fee. |
Claims | You don’t have to worry about filing claims. Your network dentist will file them for you. | Once you use a network provider, they will file your claims for you. If you receive care from a non-network dentist, you will likely will have to file your own claim. |
Deductibles | You pay no deductibles. (This is a specific dollar amount you must pay before the insurance carrier will pay towards your claims.) You are simply responsible for your copayment at the time you receive services. | You do pay an annual deductible. This amount varies by insurance company and by plan. |