Navigating the world of dental insurance can be complex, with various plans and coverage options available. One common type of dental insurance plan is a Dental Health Maintenance Organization (DHMO).
If you’re unfamiliar with DHMOs and how they work, you’re not alone. Learn about the intricacies of DHMOs, how they differ from other dental insurance plans, and the benefits they offer to members.
Understanding DHMOs
DHMO insurance plans offer cost-effective coverage primarily emphasizing preventive care. Members are required to seek treatment from in-network dentists to access coverage, although some plans may permit opting out of the network at a reduced coverage rate through a point-of-service provision.
While DHMO networks may be smaller compared to those of Preferred Provider Organization (PPO) plans, the premiums are significantly lower, offering greater potential for savings.
Key features of DHMOs
Before selecting a dental insurance plan, it’s a good idea to be familiar with its features to ensure it’s the right fit for your needs. Below are some key features of DHMOs:
- Network of dentists: DHMOs typically have a network of participating dentists, dental specialists, and dental facilities. Members are required to choose a primary care dentist (PCD) from within the network, and this dentist will serve as their primary provider for routine dental care. They’ll also referral to specialists if needed.
- Predictable costs: One of the primary advantages of DHMOs are predictable costs. Members pay fixed copayments for covered services, eliminating the need to worry about deductibles or coinsurance. This can make budgeting for dental expenses more manageable for individuals and families.
- Comprehensive coverage: DHMOs often offer comprehensive coverage for preventive, diagnostic, and restorative dental services. This may include routine exams, cleanings, X-rays, fillings, extractions, and other basic dental procedures. Some plans may also provide coverage for more extensive services such as crowns, bridges, and dentures, although these may require higher copayments.
- Focus on preventive care: DHMOs prioritize preventive dental care as a means of maintaining optimal oral health and preventing more serious dental issues in the future. Routine preventive services such as exams, cleanings, and X-rays are typically covered at little to no cost for members, so regular dental check-ups and early intervention for dental problems are encouraged.
- Referral system: In DHMOs, members must obtain referrals from their PCD before seeing a specialist within the network. This referral system helps with the coordination of care and ensures that members receive appropriate treatment from qualified providers within the network.
Is a DHMO plan right for you?
DHMOs offer an affordable approach to dental insurance, providing members with access to a network of participating dentists and comprehensive coverage for preventive, diagnostic, and restorative dental services.
By prioritizing preventive care and offering predictable costs, DHMOs help members maintain optimal oral health while managing dental expenses effectively. If you’re considering dental insurance coverage, Delta Dental of Colorado’s DHMO options could be a smart choice for you and your family.