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What You Need to Know About HMO And PPO?

We do not care about our teeth as much as we should. Yes, brushing and flossing regularly is necessary. But this is not enough. It is necessary to visit your dentist from time to time. Apart from fearing your dental appointments, you may also dread the cost. Hence, having a dental insurance in OKC or in any other state is very important. The primary two health insurance options are Health Maintenance Organization or HMO and Preferred Provider Organization or PPO. If you are not sure which plan to choose, here is a comparative discussion that you should go through.



Differences Between the Two Plans:


In addition to the different names, the two types of policies offer different advantages that will interest you.


  1. If you have HMO or Health Maintenance Organization dental insurance in Edmond, OK, you cannot see the specialist at first. You have to get yourself checked by your primary care provider. If your care provider is not able to treat you, they will refer you to the specialist. However, having a Preferred Provider Organization allows you to see your specialist dentists directly.

  2. Having an HMO insurance does not allow you to see specialists who are outside of your network that is approved by the dental insurance. But with a PPO plan, you do have a network of service providers. But you can see other specialists who are not approved by your insurance.

  3. Even though you cannot go outside the approved network of providers with an HMO, you get the most coverage out of your insurance plan. However, when it comes to PPO, it is not the same. When you see a dentist who is out of the approved network, you do not get as much coverage as you should if you see a specialist within the network.

  4. With HMO, your premium is typically much lower in comparison to PPO. For the coverage you get outside your approved providers’ network, you need to pay high premium.

  5. HMO is much simpler in comparison to PPO. When you opt for PPO, it might include copay, deductibles, or coinsurance. Your plan will determine whether you will have to pay your premium for copay or deductibles or coinsurance.

Apart from HMO and PPO, there are some other dental insurance options that you can choose from. However, we recommend you seeing a health insurance brokerage such as Oklahoma Health Options. We will guide you in understanding and choosing the policy that is best for you.

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