I have an HMO Dental Insurance Policy. Can I come see you?


Unfortunately we can not accept HMO and DHMO dental insurance plans.  However, we are a small dental office and would like to work with you however we can!  But let's explain the nature of a HMO plan vs. a PPO plan.

With the HMO plan you may pay slightly less (or the same) as the PPO plan but you do not have the option of chosing your provider.  You are assigned a provider and added to that office's roster.  That office is paid for each patient on their roster no matter how many times that patient walks through the door.  You may never use your dental insurance and that specific office gets paid for each month you are considered assigned to them.  It also can be complicated when referring to a specialist as there needs to be a specialty referral and you need to be added to their office roster.

With a PPO plan you have the flexibility of choosing your provider.  There are more to choose from and the insurance reimbursement is a little more predictable.  With HMO's, the reimbursement is very low many offices will charge the patient enhancement fees to make the treatment more profitable because as a tradeoff for being paid for each patient assigned to them, the offices accepting HMO plans are agreeing to a lower fee schedule for reimbursement for treatment.  To cover the cost of overhead and dental materials the office may over treat or over diagnose or kick back many charges to you as the patient.  Worse, there is very little reimbursement for any diagnostic and preventative treatments so many times small cavities or gum disease goes years without being discovered or addressed!

Now this is not ALWAYS the case.  Just as there are different people in the world, there are different dentists, different dental offices.  We have heard of great experiences on HMO plans.  It's just that no one writes home about the good experiences, right?!