A PPO plan is the most common dental option for seniors. This plan provides dental insurance within a provider network. Patients that stay within the network are offered lower fees and lowered plan deductibles. PPO plans offer the most flexibility in choosing a dentist. This is also the preferred plan of most dentists because they receive payment the quickest. The result is less wait time to see the dentist and less paperwork.
Dental Health Maintenance Organization Plan
In a DHMO plan, dentists within a network provide dental coverage to its members. With this option, the patient is required pre-payment for services. If you go outside the dental provider network, you will be responsible for dental bill in its entirety. Also, with this plan, dentists are paid set fees as opposed to being paid in full as with the PPO plan. Therefore, more dentists will choose a PPO network, resulting in fewer options for choosing a dentist in your network. The wait times are also longer with this insurance, you may have to wait months for basic services.
Exclusive Provider Organization
An EPO plan consists of a network of dentist partnering with the insurance company to offer services at a discounted rate. Similar to an HMO plan, there are no out of network benefits therefore restricting the number of dentists that are available for its members. Many drugs and specialized services are not covered under this plan. Also, most high quality dentists will not participate in an EPO because of the reduction in provider fees. Lastly, patients may be required to submit their own claims and are subjected to timely filing limits.
Dental Indemnity Plans
Often called a fee for service plan, dental indemnity plans gives its participants the option to visit any dentist that they wish. Participants of this plan are required to pay deductibles in exchange their services are paid between 80% and 100% of “usual and customary” dental costs. However there is often a maximum benefit limit and any services exceeding that amount will be the responsibility of the patient. There are also wait times for certain covered services and you may have to pay out of pocket until you are fully covered by this plan.