HMO, DHMO, PPO…..are you lost yet?
Picking the right insurance policy can sometimes feel like apple picking, and finding out you picked the bad apple after the first bite. It can be difficult finding the right one for you and/or your family.
At Tribeca Dental Studio, we accept PPO, which stands for Preferred Provider Organization. PPO allows you the flexibility to practically go anywhere you want, because it allows maximum coverage for in-network providers, and they’re usually really great with out-of-network too. And you can visit any provider you choose without a primary physician referral, which is sometimes mandatory with certain plans.
Like an HMO plan (Health Maintenance Organization) PPO plans have a roster of doctors and hospitals you can visit in addition to the flexibility of choice. Unlike HMOs, however, PPO networks do provide coverage for out-of-network. Using a provider who is not in the PPO network will still be covered by your health plan, but you might have to pay slightly more depending on which Insurance plan you choose.
Requiring a PCP (Primary Care Physician) can save you a few dollars, but it adds an extra step that can sometimes be frustrating. Because PPO plans don’t require that mandatory referral, they are more convenient but it might end up costing those $$$’s anyway. Personally, I don’t like to wait any longer for my care than I have to, so I find it worth having the flexibility to do what I want, when I want.
An HMO gives you a certain list of providers and practices within its network. Unlike PPO, care under an HMO plan is covered ONLY if you see a Dentist in their network. Also, there are more restrictions than other plans, such as allowing only a certain number of visits, tests or treatments. If you choose to see a doctor outside of an HMO network, there is no coverage. Zip. Nada. Meaning you will have to pay the entire cost of whatever appointment you have under that plan. So if you came here and didn't want to go anywhere else for that cavity filling, we’d have to use other forms of financial assistance if you don’t want to pay completely out of pocket right there.
Insurance can be a complete headache if you don't have a clear plan of where you want to go for all your dental needs, I get it. If you are comfortable with a plan that requires PCP and you don’t want to worry about paying out-of-pocket at all, HMO might just work for you. However, because I love my job and I know by experience how skilled our doctors are here, PPO is always my suggestion. The flexibility to choose who works with you, the guarantee that you can go to a highly regarded doctor any time you need without the extra step in getting a referral, the small co-pay, it all adds up under the umbrella of convenience.
For the people who want to skip the line and go strait to the Dentist without Insurance...
If you don't have insurance and don’t want to deal with the hunt for the right apple, or prefer paying out of pocket, I will happily point out that we created a super convenient, private membership insurance exclusive to TDS that gives you full unlimited coverage for preventative care, with a percentage off any major treatments to save you some bucks. You should definitely call one of us and ask how that can help take care of that filling, or even cosmetic teeth whitening. article that gives accurate information that I found to be helpful myself.
Choose what works for YOU! If it costs a tiny bit more for all the bells and whistles, it might be worth it if you are a regular visitor to the dentist and you want to do it all on your terms. But if you prefer to put away the extra cash for your next vacation, I don't judge one tiny bit, just take me with you. I'm a great travel buddy. Always remember, when apple picking, avoid bruising, and use them up so you don't end up wasting what you paid for!
With Love and Health,
Haylee Grosvenor