DENTAL INSURANCE 101 (PLAN TYPES & DENTAL-SPECIFIC TERMS)

1. Types of Dental Insurance Plans

PPO (Preferred Provider Organization)
Most flexible; covers in-network and out-of-network.

HMO / DHMO
Requires selecting a primary dentist; network restrictions.

EPO
Only covers in-network; no out-of-network coverage.

Indemnity
Reimbursement-style; patient can see any dentist.

2. Network Status (Critical for Verification)

In-Network

• Lower patient fees

   

• Contracted rates

   

• More predictable coverage

   

• Better benefits

   

Out-of-Network

• Higher patient cost

   

• Some plans pay less or nothing

   

• Deductibles and percentages may differ

   

Always confirm network for all offices

It directly affects patient cost and office estimates.