YOU ASK:

What is better indemnity insurance or HMO dental plans?

WE ANSWER:

To help us answer this question, let us take a quick look at how both kinds of dental plans work.

In an HMO dental plan, you will need to go to a dentist that is included in the list of accredited doctors. That means that you can't just go to any doctor you want - you have to get your dental treatments from a dentist that belongs to the HMO network.  If you want to avail of a treatment from a dentist outside of the network, you will have to pay the entire bill.  There are also instances when you need to wait to avail of a dental service since there are a lot of HMO patients who have already lined up for the service.

The advantage is that for basic dental treatments, you don't have to shell money out when you avail of the treatment. You will only need to cover some of the costs for selected dental procedures. And, as long as you are eligible, dentists cannot turn you away.

In contrast, dental insurance providers usually have a list of accredited dentists in the network. You can, however, opt to get the treatment from a dentist outside of the network if you are willing to accept financial penalties involved.

You will also need to pay a deductible on any dental treatment you avail of. You may also need to pay the dentist and then claim for a reimbursement from the insurance provider.

There is also a fee schedule which lists the treatments you can avail of, as well as how much the insurance provider will pay for the treatments. This means that it will only pay you up to the amount listed, the rest of the balance will be shouldered by the patient. For example, if a root canal has a fee schedule of $200 dollars and your dentist's charge for the root canal is $300, you will have to pay for the deductible, as well as the extra $100 that the insurance plan does not cover.

The decision on whether an indemnity or an HMO dental plan is better depends on the level of service you want, as well as whether it is okay for you to get the service from a dentist included in the list of providers.

Was this question and its answer useful?
Not a bit
  • Currently 4.2/5 Stars
  • 1
  • 2
  • 3
  • 4
  • 5
Very useful
Have a question about insurance? Ask the experts
Share: