HMO Dental Insurance, understanding how dental insurance works
I don’t understand how dental insurance works. I have a dental insurance PPO plan through my job, but it could be better. I am considering removing it and getting just the medical. My questions are as follows: Would an HMO be better? I want to avoid paying the dentist in full and wait for money back from the insurance company, which I currently have to do. Why have insurance if you have to pay the dentist?
Reply: It is essential to understand how claims are filed with a PPO, how the dental office processes claims, and how they expect to get paid. Understandably, a dentist would want to get paid for the services they provide at the time provided. Yet some dental offices may let you make a partial payment until your company pays, then charge you for any additional amounts due not paid by your dental insurance company. That is where you need to ask your dental office about their process so there are no surprises.
With an HMO dental insurance plan, there are no claims forms to fill out as the cost is fixed. You are provided a fee schedule for all the dental services covered by the plan, and you pay that amount to the dentist when service is rendered. You may like an HMO since you know your cost before having any dental service. An additional benefit of an HMO is that they typically do not have waiting periods or deductibles. However, you may need to choose a different dentist as you do have to pick an in-network provider with a dental HMO.