dental care

HMO Dental Insurance
The HMO Plans Facts, The Pros, The Cons

An HMO Dental Insurance stands for a dental insurance offered by a Health Maintenance Organization.

In some instances, an HMO dental plan is called a capitation dental insurance. This form of dental coverage offers members a wide range of dental providers to choose from.

However, HMO dental plans are different from PPO dental plans.

Both are highly demanded nowadays. If you get a dental plan, make sure you understand what your plan is and the difference between HMO and PPO, so you can make the most out of your plan benefits.

An HMO dental insurance can be availed of by paying a certain amount, which works like a membership fee. Once you become part of the HMO dental program, you become entitled to discounted rates when you seek dental care from a network of dentists supported by your HMO plan.

The HMO program pays the participating dentists on a monthly basis; the amounts of payments are fixed. Both PPO plans and HMO plans offer great benefits for dental patients but follow different payment procedures.

What You Can Get from an HMO Dental Coverage

Benefits you get from a HMO Dental Insurance coverage:

  • Guaranteed Dental Care
  • Dental Care within Easy Reach
  • Predictable and Affordable Dental Fees
  • Flexible Dental Plans

1. Guaranteed Dental Care

hmo dental insuranceOne of the biggest advantages of an HMO dental insurance plan is that it promises guaranteed dental care for all HMO plan members

You can be sure that all dentists participating in the HMO network you are a member of will treat you and will not turn you away regardless of how much they will get from the treatment.

There are instances when the payment from the HMO will not fully compensate for the treatment provided to you, but an HMO plan will always have you covered. This means you can get dental care every time you need it, no matter what.

2. HMO Insurance - Dental Care within Easy Reach

It is easy to avail of a dental HMO insurance plan. When you apply and pay your monthly fees, you can already get the dental care you need. Most HMO dental plans cover basic dental services such as dental exams, cleanings, and dental x-rays, all of which are usually covered 100%. You can also avail of discounted rates on a list of other procedures such as dental crowns, dentures, and bridgework.

3. Predictable and Affordable Dental Fees

A lot of people prefer HMO dental insurance because it entails predictable monthly payments. The fees are set at a certain price every month, so you can plan for your expenses ahead of time.

Aside from that, HMO dental fees are usually lower than what other types of dental plans charge for dental coverage. By going to a dentist belonging to the HMO network, you can save a lot on your dental fees.

This means you get dental care at costs you can easily afford and payment plans you can easily meet.

4. Flexible Dental Plans

HMO dental insurance plans are also known for being flexible due to the many options it offers to consumers. A lot of companies also choose HMO dental plans to offer as part of their employee benefits package.

This is because HMO dental plans allow you to choose the coverage you need and balance this with the amount of money you are willing to shell out for the dental plan. If you are considering an HMO plan, check out your options carefully before getting one.

The Downsides

However, there are significant downsides when it comes to HMO dental insurance.

The first problem arises from the arrangement between the HMO program and the participating dentist.

Since dentists are paid fixed fees regardless of the treatment they provide to patients, some HMO dental plan holders complain about dentists who do not take the best treatment for their condition.

Some HMOs are also known for long waiting periods for some dental procedures. Some members complain of waiting for months for the dental services they require.

Aside from that, since there are also dentists who are trying to avoid such a setup, HMO dental networks are considerably smaller than PPO dental networks.

Another downside is that you cannot choose an out-of-network dentist, unlike in PPO plans which allow you to choose your preferred dental care provider and still offer you discounted rates regardless of your choice.

HMO plans, on the other hand, are closed plans, so you have to settle for the dentists available in the plan.

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