PPO vs. HMO Dental plans
PPO dental plans have a deductible, a limit of coverage, and usually a 12-month waiting period before they will pay for major services. (Covered California dental plans have a 6-month waiting period).
HMO dental plans do NOT have waiting periods (except for orthodontia), so if you must have major work done immediately, an HMO may be your best option.
However, there are 3 to 5 times the number of dentists who participate in the PPO networks, compared to the HMO networks. Customers also frequently complain that HMO dentists routinely “up-sell” unnecessary procedures or attempt to charge more than the rates they are supposed to charge in the insurance contract.
If you have a particular dentist in mind or plan to ask your friends to recommend a dentist that they trust, a PPO dental insurance plan is usually the way to go.
About the Delta Dental Premier network:
Many people have a dentist that only participates in a single Dental Insurance network: the Delta Dental Premier network.
A PPO dental insurance policy pays for dentists that are both “In-Network” and “Out-of-Network”. However, there are usually big differences in the amounts that the insurance company will cover compared with an “In-Network” (participating) dentist vs a non-participating “Out-of-Network” dentist. A participating “In-Network” dentist has signed an agreement to charge a reduced rate for common procedures. Non-participating dentist haven't signed that contract, and therefore they charge more and the insurance company compensates less.
If your dentist only participates with the Delta Dental Premier network, then that is the policy you need if you want to continue seeing your dentist and get dental insurance coverage.
NOTE: Delta Dental has two different networks
- the regular "PPO" network
- the “Premier” network.
The “Premier” network is much larger. Plans that do not have “Premier” in the name are the regular "PPO" network. You can click the provider search button to see which network your dentist participates in.
Call me at 626-765-4495 and I will help you enroll or answer questions.
Dental - Vision - Short-Term Medical - Critical Illness - Accident Insurance Plans
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