What Are the Different Types of Dental Insurance?

Worries about eye-watering dental bills put many people off going to the dentist, but ignoring problems with your teeth could spell more significant issues in the future. Fortunately, dental insurance can help you access the care you need without breaking the bank.

Understanding the different types of dental insurance can help you choose the best policy for your budget and get the most out of your existing coverage. Your policy type can significantly impact your options, from choosing a dentist to access to specialist services.

Preferred provider organization (PPO) dental insurance provides a broad choice of in-network dentists and allows policyholders greater freedom to choose their own dental care provider. Furthermore, many PPO dental insurance providers cover specialist consultations and treatment without a referral letter.

As you might expect, this freedom comes at a cost. Generally, PPO dental insurance is more expensive than other types of dental insurance because you'll pay higher monthly premiums. On the other hand, it could be a convenient option if you want maximum flexibility to select your preferred provider or require specialized services.

Dental treatment can also be more expensive if you have PPO dental insurance. Seeing an in-network provider is usually more affordable than going out-of-network, but many insurers provide partial reimbursement for out-of-network treatment.

PPO dental insurance often involves higher out-of-pocket costs. Most policies include an annual deductible, and your insurer may impose a yearly payout limit. Another factor to consider is that coinsurance or copayments are often higher for PPO dental insurance enrollees. However, many PPO insurers don't charge copays or coinsurance for teeth cleaning, dental checkups and other preventative services.

What's DMO Dental Insurance?

Dental maintenance organization (DMO) insurance is usually the most affordable type of dental insurance. DMO dental insurance plans are typically deductible-free and don't have an annual payout limit. Monthly or yearly premiums also tend to be cheaper than PPO plans.

Companies typically charge DMO enrollees set copays for dental consultations and treatment, so you'll know your out-of-pocket costs from the get-go. Copays for preventative and routine care are often nominal, and most insurers waive copays for these services altogether.

However, this type of dental insurance usually has limitations to keep costs low. DMO plans tend to have smaller networks of dentists, and you may have to enroll with a pre-approved primary dentist. You'll usually need a referral letter to see a specialist.

Another potential disadvantage of DMO insurance is that your insurer is unlikely to cover services from out-of-network providers. Therefore, you'll pay out of pocket if you want to see a dentist outside your insurer's approved network.

DMO dental insurance could be an ideal option if you want access to affordable routine and preventative dentistry and are happy to stick within a narrow network of providers. However, it may be unsuitable if you want the freedom to choose your own dentist or need access to unrestricted specialist care coverage.

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How Do I Know Which Type of Dental Insurance I Have?

You can find out which type of dental insurance you have by checking your policy documents. If you can't find the documents or don't understand the contents, you can call your insurer's helpline to ask about your policy type and coverage.

PPO Dental Insurance Vs. DMO Dental Insurance: Which Is Better?

PPO and DMO dental insurance policies both have benefits and drawbacks, and there are also certain similarities. Both types of dental insurance can reduce your out-of-pocket costs when you receive dental care. Furthermore, they both have a network of approved providers contracted to provide treatments at pre-agreed prices.

Often, DMO plans are the best option for people on a tight budget. They can also be suitable if you have complex dental needs or require major dental surgery because they don't usually have annual payout limits. You could end up paying more out of pocket as a PPO enrollee if your care costs exceed your policy's payout limit.

On the other hand, PPO plans offer significantly more flexibility. PPO dental insurance could be a better choice if you have a preferred dentist who isn't part of your chosen insurer's network.

Remember that the benefits of PPO and DMO plans vary significantly between providers. It's essential to research the pros and cons of each insurance company and policy before purchasing a plan to ensure your coverage meets your needs. If you're unsure, an experienced dental insurance agent can help you choose the right policy for your budget and requirements.