The difference between HMO and PPO Dental Plans.

Understanding the difference between HMO and PPO dental plans can be very confusing. The main reason for this is it is hard to figure out what dentist accepts what plans, how big is each dental insurance plans dentist network, how high are the plans deductibles, and between HMO and PPO dental insurance, which is the most, or least, expensive? Without the proper information, it can be very difficult to chose the right plan that won’t end up costing you in the long run. We wanted to help you by outlining the benefits and challenges of both and HMO and PPO dental plan.

HMO dental insurance is a great option for someone who may have an immediate dental need. Once you are enrolled, there are no waiting periods and you can start seeing a dentist immediately. The issue that arises with an HMO dental plan is the provider network can be relatively small. If you can’t find a Dentist that accepts an HMO dental plan in your area, you may have to travel to another city to receive your annual checkups or dental procedures.

• Less expensive
• No waiting periods
• No annual deductibles
• No maximum payout limits by the insurance company

There are a much smaller network of participating dentists that accept HMO dental plans.

The main drawback to these dental insurance plans is that they have a much smaller network of dentists who accept HMO plans. If you have a dentist in your area who accept an HMO plan, HMO could be a great option for you.

Below is a PDF of the dentists that take a Delta Dental HMO plan here in California.

Before you make your selection, make sure to reach out to the dentists on this list to see if they are still accept HMO dental insurance plans. Unfortunately, dentists will drop HMO without notifying Delta Dental.

Dentists that accept Delta Dental HMO Plans

Compared to an HMO dental insurance plan, PPO dental plans are more expensive. They have annual deductibles and waiting periods from six to twelve months for fillings, crowns, and root canals. Many individuals choose a PPO dental plan because there are no dentists in their area that accept an HMO plan or their current dentist, or the one they want to start seeing, only accepts PPO dental plans.

• Most California dentists accept some form of PPO Dental Insurance

• More expensive
• Annual deductibles
• Annual maximum payouts between $1,000 – $3,000
• Waiting periods:
• • 6 Month waiting period for fillings
  • One Year waiting period for major work (crowns, root canals, bridges, and dentures, extractions)

The overall difference from an HMO and PPO Dental Plan comes down to two things: cost and dental network.

HMO can be less expensive than a PPO Dental plan. However, not that many dentists accept the HMO plan. If you are able to find a dentist that accepts the HMO plan, then you could be saving an immense amount of money on your dental insurance.

Although a PPO plan is more expensive, most dentists accept a broad range of PPO plans. Be it a plan from Delta Dental or a plan from Blue Shield. There are higher monthly premiums and longer waiting periods associated with a PPO dental plan. However, you can keep your current dentist or find a new dentist with relative ease. Under a HMO dental plan, if you move away, or your dentist retires, you may not be able to find another dentist that accepts the HMO plan.

The great thing about being covered under an HMO or PPO dental plan is that there are no waiting periods for diagnostic or preventative care (cleaning X-rays and exams).The purpose of dental insurance is to keep up on regular maintenance to prevent any major work (crowns, root canals, bridges, extractions, and dentures) from occurring in the first place. Although there are differences between both an HMO and PPO dental plan, having either plan will help you save money in the long run. The whole purpose of having dental insurance is to prevent the need to have to pay for big procedures out of pocket. 

Now that you have learned more about the differences between an HMO and PPO dental plan, feel free to fill out the form below and get a quick dental quote. Need some help and want to make sure you are making the right choice? Feel free to reach out to us and we will be glad to assist you.