Overview- Both HMO (Health Maintenance Organization) and PPO (Preferred Provider Organization) dental insurance plans in California have their advantages and disadvantages, as it will be discussed in this article. It depends on what you are looking for and what type of coverage best fulfills your requirements. Some people strictly rely on an HMO plan, or the PPO, and are reluctant to choose the opposing insurance. However, both plans are rather similar in many aspects. The factor that makes them distinct is how the benefit or deficit affects the applicant.
Availability- While both California dental insurance plans offer affordable options, in HMO plans, it is harder for an applicant to seek dentists outside a network. They are completely restricted, so you cannot assume financial penalties, or consult a non-network dentist even in a case of emergency. On the other hand, with PPO plans you have a much broader network of dentists that are available to you.
Costs Involved- A major difference between HMO and PPO dental insurance plans in California, however, involves how a payment is made to a dentist. In a PPO dental insurance plan, dentists who are a part of the network guarantee lower costs for a patient. This is typically compensated by a specific insurance provider in exchange for the referrals from the insurance company that brings them more business. In spite of that, dentists get paid in full for the services rendered. Conversely, with an HMO dental insurance plan, dentists are given a specific fee. In some instances, however, HMO plans imply that the less treatment a dentist delivers, the more money-spinning actually the deal is.
Prefer-ability- Patients have expressed concern that, in extreme cases, dentists tend to complicate the accessibility of an HMO plan. Majority of the HMO plans also have a patient quota that the dentists have to abide by. They must entertain a certain number of patients per day to avert penalty or getting terminated from the group. For this reason, there is no sufficient time to talk with your dentist past your examination point. They must keep it short so they can render more patients. There is also a model of Capitation that places restrictions on contracted doctors to a specific amount of money for each patient every month, no matter if he/she is sick or well. Even in the best conditions, since most dentists favor PPO dental insurance plans, some of them join PPO networks. If you require instant coverage, you may want to apply for an HMO plan because there is a less waiting period and no benefit maximums.