DHMO Insurance – All You Need to Know

When it comes to dental care, many people rely on dental insurance to help them cover the costs of routine check-ups, cleanings, and other dental procedures. However, dental insurance plans can be confusing and overwhelming, especially if you’re new to the world of dental insurance.

In this article, we’ll explore one type of dental insurance – DHMO insurance – and how it works, what it covers, and how it differs from other dental insurance plans. We’ll also answer some common questions about DHMO insurance to help you make an informed decision about your dental insurance needs.

What is DHMO Insurance?

DHMO stands for Dental Health Maintenance Organization. DHMO insurance is a type of dental insurance plan that works like a HMO medical insurance plan. With a DHMO plan, you’ll be assigned a primary dentist who will be responsible for managing your overall dental health and coordinating your dental care.

Unlike traditional dental insurance plans, a DHMO plan doesn’t require you to pay an annual deductible or meet a certain annual maximum. Instead, you’ll pay a flat monthly fee for your dental care, and your primary dentist will decide which dental services you need and when you need them.

Because DHMO plans are designed to promote preventative dental care, they usually cover routine check-ups, cleanings, and other preventative services at little or no cost to you. However, they may have more limited coverage for more expensive or complex dental procedures.

How Does DHMO Insurance Work?

When you sign up for a DHMO plan, you’ll be assigned a primary dentist who will be your main point of contact for all your dental care needs. You’ll need to see your primary dentist for routine check-ups, cleanings, and other preventative services. If you need more complex dental procedures, your primary dentist will refer you to a specialist within the DHMO network.

With a DHMO plan, you’ll pay a flat monthly fee for your dental care, which is usually less than the monthly premium for traditional dental insurance plans. However, you’ll need to pay a co-pay for some dental services, such as fillings or extractions.

One of the benefits of a DHMO plan is that you don’t have to worry about annual deductibles or annual maximums. Instead, you’ll pay a flat fee each month, and your primary dentist will determine which dental services you need and when you need them.

What Does DHMO Insurance Cover?

Most DHMO plans cover routine check-ups, cleanings, and other preventative dental services at little or no cost to you. This is because DHMO plans are designed to promote preventative dental care as a way to prevent more expensive dental procedures down the road.

However, DHMO plans may have more limited coverage for more expensive or complex dental procedures. For example, some DHMO plans may not cover orthodontic treatments or dental implants. If you need more complex dental procedures, your primary dentist will refer you to a specialist within the DHMO network.

How Does DHMO Insurance Differ from PPO Insurance?

Another type of dental insurance plan is a PPO, or Preferred Provider Organization, plan. PPO plans allow you to choose your own dentist, and you’ll pay a co-pay or co-insurance for each dental service you receive.

While DHMO plans are more focused on preventative dental care, PPO plans usually offer more comprehensive coverage for more expensive or complex dental procedures. However, PPO plans may have higher annual deductibles and annual maximums than DHMO plans.

FAQ About DHMO Insurance

Is DHMO insurance more expensive than traditional dental insurance?

No, DHMO insurance is usually less expensive than traditional dental insurance. This is because DHMO plans are designed to promote preventative dental care, which can help prevent more expensive dental procedures down the road.

Do I need to choose a primary dentist with a DHMO plan?

Yes, with a DHMO plan, you’ll be assigned a primary dentist who will be responsible for managing your overall dental health and coordinating your dental care. You’ll need to see your primary dentist for routine check-ups, cleanings, and other preventative services. If you need more complex dental procedures, your primary dentist will refer you to a specialist within the DHMO network.

What happens if I need a dental procedure that’s not covered by my DHMO plan?

If you need a dental procedure that’s not covered by your DHMO plan, you’ll need to pay for it out of pocket or find a different dental insurance plan that covers the procedure.

Can I choose my own dentist with a DHMO plan?

No, with a DHMO plan, you’ll be assigned a primary dentist who will be responsible for managing your overall dental health and coordinating your dental care. You’ll need to see your primary dentist for routine check-ups, cleanings, and other preventative services. If you need more complex dental procedures, your primary dentist will refer you to a specialist within the DHMO network.

Is orthodontic treatment covered by DHMO insurance?

Some DHMO plans may cover orthodontic treatment, while others may not. If you need orthodontic treatment, you’ll need to check with your DHMO plan to see if it’s covered.

Conclusion

While DHMO insurance may not be the best choice for everyone, it can be a good option for those who want to focus on preventative dental care and avoid high annual deductibles and annual maximums. By understanding how DHMO insurance works and what it covers, you can make an informed decision about your dental insurance needs and find a plan that works best for you.