Dental PPO Vs. HMO

Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs) are the two primary insurance options available for dental care. HMOs permit you to visit your primary dentist at your choosing but require a referral prior to seeing a dental specialist. PPOs allow the customer to call any dentist he chooses without first seeing a primary dentist.

Networks

• HMOs are limited to a specific network of dential providers and the patient must not go outside that network. PPOs allow the patient to choose any dentist, but the patient will pay a higher fee if care is sought outside the network.

Visiting the Dentist

• The HMO patient will be looked at first by their primary dentist and will recieve an authorization form allowing the patient to see a dental specialist. The PPO patient will contact their insurance carrier to view a list of participating in-network providers and can subsequently call a dentist of their choosing.

Paying for the Visit

• As an HMO patient, your insurance provider will handle the bill as long as you see the provider that your primary dentist assigned to you. As a PPO patient, you will only be responsible for the additional fees that are tacked on as a result of going out of network to see a dentist.