Should I get a PPO or an HMO dental insurance?
It might be that time again to select which dental insurance plan you are going to choose for the upcoming year. Some of you might face the dilemma of having to choose between two most common types of dental insurance: a PPO or an HMO plan. You first need to understand the benefits of a PPO and HMO dental plan in order to make an informed decision.
If you’ve done some research, then you might have figured out the basic difference between a PPO and HMO dental plan. Essentially, PPO plans cost more but also offer better coverage than HMO plans. While that is generally true, it doesn’t quite explain which plan is going to better suit your needs. So how can you determine if a PPO or HMO plan is better suited for your needs? Is it worth paying the extra bucks for PPO coverage? Or should you go with a less expensive HMO plan to save on your monthly payments?
Benefits of PPO dental plans
PPO plans cost more than their HMO counterparts but also offer better services. Here are the benefits of PPO dental plans which might justify their additional cost:
PPO dental plan pays directly towards your dental treatment
A PPO plan is much better than an HMO plan if you need to receive major treatment. Major dental treatment refers to more costly and time consuming work such as root canal, dentures or crowns. On the other hand, simple treatment refers to more basic ones such as a cleaning or filling.
Simple cleanings are typically covered by both PPO and HMO plans and the difference in copays is negligible. However, PPO dental plans directly pay your dentist for major treatment, whereas HMO dental plans only offer discounted rates on your treatment. This makes a big difference if you’re in need of a lot of dental work.
PPO dental plans directly pay towards your major dental work
PPO dental plans pay a substantial portion towards your total expenses for major dental treatment. Of course you may still be responsible for additional copays and deductibles, but you’ll get significant coverage from your PPO plan. Should you ever require major treatment, you’ll save lots of money with a PPO over an HMO dental plan.
HMO dental plans only offer discounts on major dental work
HMO dental plans typically only cover basic treatment in full, things such as X-rays, simple cleanings and possibly dental fillings. For major dental treatment, HMO plans offer you a discounted rate. So your dentist doesn’t actually get paid much, if anything, from your HMO plan towards that root canal or crown you need. And if your dentist isn’t getting paid then bad things can happen. They might postpone necessary treatments, refer you to a specialist who charges much more, or attempt to bill you for additional upgrade fees to make it worthwhile their time.
In conclusion, a PPO plan goes much further than an HMO if you ever require advanced dental treatment. In fact, an HMO dental plan can often times leave you feeling as if you would’ve been better off without having dental insurance altogether!
PPO dental plans are a better choice if you require substantial dental treatment
If you’ve allowed your dental work to pile up for a good while and expect to require a whole bunch of treatment, then a PPO plan is definitely the better choice. You will end up saving quite a bit on copays while also receiving much better coverage towards your treatment with a PPO over an HMO plan.
If you’re anticipating the need for treatment such as a deep cleaning, wisdom teeth removal, crown and bridges, root canals, etc. then don’t even consider not choosing a PPO dental plan, if given the option. Generally speaking, the more dental work you require, the more benefits of PPO plan you shall notice.
You will have access to many more dentists with a PPO dental plan
Another major benefits of PPO plans is that it gives you access to a larger network of dentists. If you’ve already had extensive dental work, then you should know that not all dentists are created equal. Dentists fresh out of school are still learning as they go and you don’t want to be their guinea pig! On the other hand, those that have been around for one too many years may be falling behind on technological advancements and developing shaky hands or compromised vision.
The most successful and best dentists typically limit their dental practice to only private and PPO patients. Many of them refuse to accept HMO dental plans since reimbursements are not that great. With HMO dental plans you will get assigned to a pre-determined dentist who is in your HMO network. It could be difficult to switch out to another one if you end up not liking the one you’re assigned to. Not to say that there aren’t any good dentists that accept HMO dental plans, as that is certainly not true, but it can be much harder to locate the good HMO providers.