California Life-Only & Accident and Health AgentRelated Benefits and ProductsMedium
Which type of dental insurance plan typically allows policyholders to choose any dentist they wish, but often requires them to pay a higher percentage of the costs if they go out-of-network?
- AIndemnity Dental Plan
- BExclusive Provider Organization (EPO) Dental Plan
- CDental Health Maintenance Organization (DHMO)
- DPreferred Provider Organization (PPO) Dental Plan
Show answer & explanationAnswer & explanation
Correct answer: D. Preferred Provider Organization (PPO) Dental Plan
PPO dental plans offer flexibility to choose any dentist but incentivize using in-network providers by offering higher coverage percentages for them. Out-of-network care is still covered, but at a lower reimbursement rate.
Why the other options are wrong
- A. Indemnity plans typically pay a set amount for services regardless of the dentist, without network restrictions or differential coverage based on network status, though they are less common for dental.
- B. EPO plans require members to stay within a specific network, with no coverage for out-of-network care except emergencies.
- C. DHMOs typically restrict choice to a specific network and require a primary dentist.
PPO Dental Plan
A type of managed care dental plan that offers a network of preferred providers but also allows members to receive care from out-of-network dentists, albeit usually at a higher cost.
- Greater flexibility in dentist choice.
- Lower out-of-pocket costs for in-network care.
- No primary care dentist required.
Memory trick: Networks vary, choose with care!