An HMO dental insurance may just be the type of dental insurance plan you are looking for. HMO is short for Health Maintenance Organization. This means the plans are offered or maintained by an organization whose objective is to encourage well-maintained dental health among its members. Although it has become associated with having a lot of restrictions, it is unquestionably one of the cheapest dental coverage options in the market. And what makes it an even popular choice is that it may be cheap, but for its price, it already offers a tad more than other options do at that price range.
If the concept of HMO dental insurance is still not clear for you, here’s a more in-depth look at this type of dental insurance plan.
An In-Depth Look at HMO Dental Insurance
- How an HMO dental plan works
- Why it’s the common employee dental insurance choice
- What HMO dental insurance covers
1. How an HMO dental plan works
An HMO plan gives a member access to reduced-fee dental services from dentists that the HMO provider has entered into an agreement with. The agreement is that the dental plan will pay the dentists a set amount every month for them to take care of the dental health of the HMO’s members. Each member has to choose one dentist who will serve as his or her primary dental care provider, and each dentist will be paid a separate fee for each member that they are assigned to. Members, on the other hand, has to pay for the procedure they avail of out of their own pockets, but costs are already reduced and will be based on a specific fee schedule released by the HMO provider.
2. Why it’s the common employee dental insurance choice
It is a known fact that more people prefer PPO dental plans, which is the strongest competitor of an HMO dental plan. PPO dental plans or Preferred Provider Organization plans are considered as better mainly because they offer more flexibility, especially in the choice of a dentist. PPO members can go to any dentist and get discounted rates, regardless of whether the dentist belongs to the same PPO network or not.
However, HMO dental insurance manages to stay afloat because it has monopolized one segment of the market. It is now considered as the most common choice for companies looking for an employee dental insurance plan to offer to their employees. Employers in this position are bent on getting a good dental insurance plan that can easily cover groups but won’t cost them a lot. Since PPO plans are more costly, a lot of companies opt for an HMO group dental coverage for all their employees instead.
3. What HMO dental insurance covers
Your HMO dental insurance plan can cover almost all dental procedures you may find the need for. This usually depends, however, on the company providing the said plan. Some companies offer bigger coverage, while some offer pretty limited coverage. The usual fare, however, includes basic dental procedures such as dental exams, x-rays, cleanings, and checkups as well as major dental procedures such as dentures, bridges, crowns, bonding, and so on. In some special cases, your HMO plan can also provide some coverage for braces or cosmetic care, but this quite rare since it goes against the objective of an HMO plan. HMO plans try to keep rates down and focus on providing first-level needs instead of taking aesthetic aspects into consideration.
The danger with HMO dental insurance
But before you get an HMO dental insurance, just to be sure that you know what to expect from such a plan, you should also know about the main danger you face when you get an HMO dental plan. Since dentists are paid a set fee every month, the compensation they get is not relative to the dental procedure they do or the dental care they provide. Due to this, there are a number of dentists who do not provide the best-quality care since they feel like they’re not getting compensated enough. Before purchasing an HMO dental insurance, make sure to ask a few questions about what benefits the dentists are receiving and how the dentists and the HMO plan provider are working together to help prevent any problems related to this.