Question: I have been on line now for the last four days getting overwhelmed with all the different types of dental insurance plans and how they work. I am so confused at this point that I am ready to give up the hunt for dental insurance and just try to pay for my dental needs our of pocket.

Before I do toss in the towel so to say can anyone explain to me what is the difference between a dental HMO and a dental discount plan. What is a PPO? Everyone tells me I should pick a plan were I can choose my own dentist but I really do not have a dentist. So does that then matter?

Reply: Shopping for dental insurance and or a dental plan can get to become over whelming if you are not sure what is best for you and your dental needs.

Dental Discount Plans: A discount plan is really great if you have current dental needs that have to be address right away. Such as a toothache. Since most dental discount plans start the next business day from signing up. Thus allowing you to see the dentist right away as well as reducing your dental costs.

Another great benefit with a discount plan is that you get discounted saving off on dental services that may not be covered under most dental insurance plans. Such as Whitening, Veneers and Implants to name a few.

Note: A dental discount plan is not dental insurance, therefore it is not a filed product with the department of insurance. You must stay within the network of providers . Only the network dentist have agree to reduce or discount their cost to you as a plan member.

Dental HMO’s Insurance: HMO’s are insurance plans, also known as “capitation plans,” operate like their medical HMO cousins. This type of dental plan provides a comprehensive dental care to enrolled patients through designated provider office.

Generally speaking HMO do not have waiting periods, yearly maximum limitations or deductibles. Like a dental discount plan you have to go to dentist that participate in the plans network. There is no out side net work coverage.

Dental PPO’s Insurance: Another true dental insurance plan, a Preferred provider organizations ( PPO). This plan allows a particular group of patients to receive dental care from a defined panel of individual dental insurance dentists. This type could be used to provide dental gap insurance.

The participating individual or family office agrees to charge less than usual fees to this specific patient base, providing savings for the plan purchaser. If the patient chooses to see one who is not designated as a “preferred provider,” that patient may be required to pay a greater share of the fee-for-service. 

A group of individual or family dentistry providers agrees to provide services at a deeply discounted rate, giving you substantial savings — as long as you stay in their network. Unlike the more restrictive DHMO, though, you can go out of network and still receive some benefits.

What was stated is generally how each type of plan works. However, each plan is different that is why it is important to read and understand the plans terms and conditions before making your final choice.