Dr Dental – Pro and Cons of Dental HMO Insurance Plans

03/30/22 5:08 AM

There are many choices to choose from when buying a dental insurance plan for you and your family.  Therefore it is helpful to understand some of the pros and cons for each type of dental plans.

Dental HMO Insurance Plans Pros:  

* Cost of the Plan: Dental HMO plans are normally lower cost plans making them easier to fit in most budgets.

* Waiting Periods for Dental Services:  Most dental HMO plans do not have waiting periods for covered dental services. Therefore if you need filling, crown, root canals etc. soon after buying an HMO insurance plan, you are able to receive benefits for these types of services right away.

* No yearly maximum payouts. HMO plans do not have a yearly maximum dollar limitations on how much the plan is going to pay per person per year.  Though there may be limitations on dental services such as two cleanings a year or one set of x-ray a year etc.

* Cost of Dental Services:  There is no guessing as to your cost for dental services since most HMO plans are fee based. The cost for covered dental services on a HMO insurance have already negotiated with the dental providers. You are able to review the fee schedule before even buying the plan.  The only exception to this  can be that plan specialist may still be based on percentage.

Dental HMO Insurance Plans Cons: 

* No outside network benefits:  Under an HMO dental insurance plan it operates through a network of dentist. Generally you are assigned to a dentist in the plan network that you pick at the time of purchase.  You can change providers by notify the company but it still needs to be a network provider of the plan.

* HMO plans tend to have more providers in densely populated area such as major cities like Los Angeles but tend to have less dental provides in more rural areas.

* Under an HMO plan normally dentist are paid a set annual fee for each customer assigned to them through the network. Which can means the dentist makes more money when a customers required less treatment. There by making some people believe that a HMO dentist will either discourage treatment or encourage dental treatment not covered under the HMO plan.

* Specialist:  Some HMO dental insurance plans either provide no coverages for specialist or limited the coverages received by specialist.  Providing on average between 20 to 30 percent savings off the cost of network plan specialist services. Note: You will generally need a referral from the general dentist to see a plan specialist

Posted by Carol | in Individual Dental Plans | No Comments »
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