Preferred Provider Organizations (PPO)
A PPO is an indemnity dental insurance that provides a network of dentists who are contracted with the insurance company to provide specific services for a set fee. These contracted dentists must follow the agreements and accept the maximum amount of coverage. Non-contract dentists may have fees that are higher or lower than the plan allows. That means if your child goes to a PPO dentist, your insurance will allow you to choose the dentist your child wants, even if that dentist is not in the network.
Dental Health Maintenance Organization (DHMO)
Under a dental health maintenance organization (DHMO) plan, contracted dentists are pre-paid a certain amount each month for each patient that sees that dentist. Dentists must provide services at little to no cost to those patients. This type of plan does not reimburse the dentist or patient any of these services, Patients must receive treatment at a designated dental office to receive these benefits.
Discount or Referral Plans
Discount or referral plans are not your typical dental plans. The company that provides these plans works with a large network of dentists. These contracted dentists agree to discount their rates or offer free services. Patients must pay for the costs of care at the contracted rate set by the plan.
An advantage with this plan is that there are no claim forms to file. These plans were originally created for individuals, but more employers are opting for these plans for their employees.
Fee-for-Service Dental Plans
Fee-for-service dental plans are also referred to as indemnity or traditional dental plans. They offer a wider selection of dentists and greater benefits than other plans. Fee-for-service dental plans are similar to PPO plans in which you pay a co-insurance and the insurance pays the remainder. The co-insurance varies by the type of coverage your child receives.
Fee-for-service plans differ from PPO plans in which a fee-for-service dentist does not receive the same reimbursement as a PPO dentist. This means that you may pay more for your child’s dental care.
Dental Discount Plans
Dental discount plans are not insurance, but they provide dental services at discounted rates. Dentists have the option to participate for an annual or monthly charge. There are many benefits to having your child join a dental discount plan. There is no paperwork or claims to fill out. There are no annual limits or deductibles.
The only catch is that your child has to visit a dentist who is participating to receive the discount. You may also be responsible for the remainder of the treatment cost than you would with a DHMO or PPO plan.