Written by: Dr. Sharanya Srinivasa DMD
Many people have dental benefits through their employer. But what about those who don’t? Is it worth it to pay for individual dental insurance? There are many different companies that provide dental insurance. Within each company there are different plans such as PPO, DMO, HMO and etc. Which one is the right one for you?
I am going to be brutally honest and tell you what it best from a dentist perspective. PPO insurance plans are among the best plans for both the patient and the dentist. One reason is that the plan pays the closest to the dental fees. It is marked down to 40% discount from the traditional dental office fees. Usually, the patient has to pay their deductible and a percentage of the procedure, usually 20%-50%. Insurance will cover the rest. How does this benefit the dentist when they are getting less than what they normally would? The dentist accepts the insurance negotiated rate so their office can appear on the insurance directory, hence getting more patients.
DMO and HMO do not pay for treatment even close to the traditional dental fee rates. They are much lower payments for the dentist but the patient pays a lower copay, or none at all. As a result there are few dentists that accept these plans. Therefore, the wait to get an appointment and the amount of time you spend in waiting room is longer. The dentist is usually overloaded with patients because they will need to see a high volume of patients in order to make ends meet in their business. As a result there may be a lower quality of care provided due to time constraints. This is just a general statement and not all offices provide poor quality care.
In conclusion, it is best to fully research each company and plan to find what is right for you. You may also want to contact the dentist you plan on visiting to see which plans they accept.