Types of dental plans

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We represent many companies and each has its advantages. We can help you determine which carrier and plan is best for you – so give us a call.

Dental HMO Insurance Plans

A DHMO provides lower cost coverage with a focus on preventive care. DHMO plans are designed to encourage regular dental visits and check-ups while minimizing spending. Any out-of-pocket costs are clearly defined, and most DHMO plans do not have exclusions for pre-existing conditions or missing teeth.

If you choose to enroll in a DHMO plan, you are required to select a primary dental facility to manage and coordinate your oral health needs. If a treatment by a specialist is necessary, the primary dental facility or dentist will first need to submit a referral. You’ll need to use in-network dentists in order to obtain coverage under a DHMO plan.

Here are a few benefits and limitations to consider when evaluating a DHMO plan:

Benefits

  • Lower premiums than PPO plans or other types of dental insurance plans
  • No deductible
  • Set copayments; often minimal or no copayment for diagnostic and preventive care
  • Typically, no annual maximum for covered benefits

Limitations

  • Smaller dentist network size
  • Referral required by primary care dentist in order to receive specialist care
  • Does not cover costs for out-of-network dental care
  • May be restrictions around the number of visits, treatments, or diagnostic tests allowed

Dental PPO Insurance Plans

PPO dental plans entail higher out-of-pocket costs than DHMO plans – but they also offer a greater degree of flexibility when choosing a dentist or dental facility.

A PPO dental plan will typically have a larger network of dental providers, and you’ll be able to switch dentists or see a specialist without a referral from a primary care dentist. In fact, you aren’t required to designate a primary care dentist when enrolling in a PPO dental plan.

If you are considering a PPO dental plan, keep in mind that you’ll pay a higher premium and will likely be required to meet a deductible.  In addition, most PPO dental plans have an annual limit on the amount of coverage 

Benefits

  • Greater flexibility overall when selecting a dentist or dental facility
  • Referral not required in order to receive treatment from a specialist
  • Depending on the plan, you may receive partial reimbursement for treatment by an out-of-network dentist
  • Larger network of dentists from which to choose

Limitations

  • Higher premiums than a DHMO plan
  • Typically involves a deductible
  • In most cases, PPO dental plans have an annual limit on coverage
  • Copayments may be higher with a PPO dental plan than with a DHMO plan 

Every insurance plan comes with its own advantages and limitations. No one plan is necessarily better than the other – it all comes down to choosing the best plan for you and your family. 

Call us! 757-420-7777

Cecil Jenkins & Associates, Inc. 757-420-7777