What is the difference between a PPO and HMO/DMO insurance?

PPO stands for Preferred Provider Organization. HMO stands for Health Maintenance Organization. Our office works with all types of PPO insurances because these plans allow you the freedom to choose any provider you’d like to see, whether they are in or out of network. We are in-network with many PPO plans.

We are not in-network with any HMO or DMO plans. These plans require that you choose an in-network dentist from a list of providers, and then see that specific provider for all your care. That’s because HMO/DMO dentists receive a check each month based on the number of patients assigned to him or her. HMO/DMO providers can be expected to perform services for a deeply discounted rate. On the other hand, PPO dentists only receive money from the insurance company if services are rendered.

Usually, patients who have an HMO/DMO plan will notice their choice of dentists is quite limited because fewer offices opt to participate in this kind of plan. However, out of pocket costs are generally lower with HMO/DMO plans than PPO plans, and have fixed co-payments. Having a PPO plan allows you to access a larger number of dentists providing higher quality care, but sometimes at a greater out-of-pocket cost. Additionally, if you have a PPO plan you can see a specialist without a referral, but if you have an HMO/DMO plan you usually need to obtain a referral before seeing a specialist.

 

 

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