Creating Wonderful Smiles
PROGRESSIVE DENTISTRY
Dental Insurance has benefited many patients and dental offices over the past 40 years. It has allowed thousands of people to take better care of their teeth and has brought many new patients into dental offices.

But now, we are seeing a significant increase in "managed health care" companies that decrease the patients freedom of choice and many believe decreases the quality of care.

Your employer may present you with this option in order to reduce their benefit costs. You can use this as a guide to help you understand and compare various benefit plans.

This table will help you understand the major differences between the 3 most popular plans of dental benefits with indemnity insurance being the best and HMO's being the worst

Traditional Indemnity Dental Insurance

These plans were the original dental benefit plans that provided good dental coverage for decades. This is the best of all three plans

 

Professsional Provider Organization
(PPO)

These organizations provide dentistry through contracted dentists who agree to accept lower fees.

Health Maintenance Organization
(HMO)

Minimum dentistry is provided through contracted dentists who agree to small monthly payments for each employee/patient regardless if services are perfomed or not.

Patients Freedom of Choice Patients choose their own dentist. (most freedom of choice) Patients have more freedom of choice than with an HMO, but pay more for care from a non preffered provider. Patients are restricted to a list of designated providers. (least freedom of choice)
Benefits The levels and coverage are defined by a contract, and generallly provide more comprehensive services  than PPO's & HMO's Enrolled members recieve services at a reduced cost when the services are delivered by a preffered provider Enrolled members recieve minimum comprehensive services when care is provided by a plan provider
Utilization May or may not be controlled by the carrier. Less controlled than an HMO Providers recieve a financial incentive to control utilization
Payment to the providing dentist Dentists are paid (indemnified) for services by the insurance company and the patients Dentists are paid on the basis of a discounted fee schedule Dentists are paid a small dollar amount per member per month regardless of services rendered
Cost to patient Usually the most expensive Less expensive than an indemnity plan Least expensive

Home Page