Dental Insurance Types in US

  • To help a larger percentage of population avail better dental care, a few of the insurance companies now provide dental insurance at minimized rates.
  • It has been made mandatory in some states in America for the employer to provide dental insurance to the employee.
  • The plans and services offered vary from one institution to another but on a broader plane the most common types of Dental Insurance types in USA are Preferred Provider Organization (PPO) and Dental Health Maintenance Organization (DHMO).
  • There is no standard amount of premium cap decided by the Government. Thus the rules and regulations regarding the amount of premiums as well as the nature of the premium (as to, whether it is co-pay or a deductable) are decided by the insurance companies.

Preferred Provider Organization

This organization consists of a group of medical professionals who are affiliated with insurance companies. Due to this business affiliation, the group of doctors, dentists etc provide their services at a reduced cost to the clients of the insurance company.

  • The Preferred Provider Organization (PPO) is the most favored type of dental insurance in USA. This is due to the utilization review. This enables the representatives of the insurer to verify the services and treatment being provided.
  •  The pre-certification requirement is also another important feature of the PPO, due to which admission in a non-emergency hospital can be done, only after acquiring specific permission from the Insurer.

Dental Health Maintenance Organization (DHMO)

A DHMO plan is one of the most common dental insurance types in USA but this type of plan has certain shortcomings.

  • The basic difference between a PPO and a DHMO is the manner in which the Dentist is paid by the insurance company.
    • In the Dental Health Maintenance plan, the payment is done on a per person basis thus making it a good example of a capitation plan. This rule in itself sometimes does not work in the favor of the patient needing medical attention.

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