What is DHMO – In Contrast to Dental Preferred Provider Organizations (DPPO)?

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In contrast to the Dental Preferred Provider Organizations (DPPO) dental insurance plan, there is the DHMO or Dental Health Maintenance Organization option, which provides less expensive insurance premiums. Under this option, dentists working under contract in this network are required to offer dental service to insured members at pre-determined rates.

This type of dental insurance plan is also preferred by some businesses due to the affordable insurance premiums. Individuals or family groups working on a tight budget often prefer this option, especially if no member of the family is covered with the benefits of a group dental insurance plan provided by an employer.

The main advantage of a DHMO dental insurance plan is the low premium stipulated by this option. However, DHMO plans will not allow an insured member to seek treatment from professional dentists outside their network. Hence, the insured members are constrained to limit their choice of dentist from among the roster of dentists under contract with the network. Should there be a need for dental specialists, such specialists shall likewise be based on the list of referrals provided by the network dentist.

The most significant difference between a DPPO and a DHMO dental insurance policy is the quality of service rendered by the dentists to the insured members. As required by the organization, dentists under DHMO are required to meet a certain quota or number of patients; hence, more often than not, dentists under the DHMO are known to spend less time in treating the dental patient under this dental insurance plan.

Filing of insurance claims for reimbursement under the DHMO is likewise criticized for being tedious due to the referral and claims procedures involved. Thus, the only definite advantage of the DHMO over the DPPO is low premium cost.

Despite its drawbacks regarding the quality of dental services and its limitations, there are still those who settle on DHMO as their preferred dental insurance plan option.