Inbox: PPO, HMO, EPO, DMO; What’s the difference?

Hello Everyone, 

From my email: 

My insurance is ending this month. There are so many policies out there..., can you please tell me what to get? What's the difference?

KNM, Lafeyette, CA.

More and more, insurance companies are being selective in the policies that they offer to patients. First, let me take a minute to let you know the difference between PPO, HMO, EPO, DMO, … UGH… it can be frustrating, I know. So, let’s go through them—

1)      HMO: Health Maintenance Organization.

With a HMO plan, your insurance company might require you to pick a dental care provider. All, or most of your services, must go through that provider. Visits to offices that take PPO only will most likely not be covered by your insurance.

2)      PPO: Preferred Provider Organization

PPO Dental offices, such as Oak Grove Dental, give you flexibility. You can most likely choose the dental care provider that best suits you and your family. You don’t need a special referral to go to these offices which is nice. But, the PPO plans usually give patients a choice on where they go to get the best care.

3)      EPO: Exclusive Provider Organization

The exclusive provider organizations usually combine the cost savings of an HMO and the flexibility of a PPO. The only down fall of using an EPO is that the dental network of providers is often limited. The insurance companies require their patients to choose a provider from a very limited network.

4)      DMO: Dental Maintenance Organization

The Dental Maintenance Organization is very, very similar to a HMO. A DMO plan is a low-cost dental maintenance plan. You are given a list of dentists in your area who have contracted to provide dental services at discounted rates. You must choose one of these as your primary care dentist, who will be responsible for your general dental services. If the provider determines that you need to see a specialist, he will refer to one without you incurring extra out-of-pocket expenses.

Wait! Hit the brakes! Some of you might be asking the question: What happens if I don’t have anything? What should I get? Don’t worry, you’re not alone. Roughly 40% of people go through every day with the constant worry that they might need some dental care and they don’t have insurance to cover it. This is why at Oak Grove Dental, we take the guess work out of figuring out what plan might work for you. We are carefully designed what we call our “Office Plan”. It is a discount program in which anyone can enroll at any time of the year to make sure their preventive appointments are maintained. And, in most cases, the cost of our program is way below the cost of getting a policy on your own. Hope this helps! If you have questions, please don’t hesitate to call our office at 925-685-2286. Until then, stay sharp and stay healthy!

Smiles,

Dr. E