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What is a Dental DMO (DHMO) Insurance Plan vs. a PPO?

Updated on September 28, 2010

What is a DMO plan?

I found out the hard way the difference between a dental insurance DMO® plan and the PPO plan I had last year. My first clue that a DMO® did not have the best coverage is when I did a search on Google and it suggested “Did you mean: Dental HMO?”

Aenta insurance owns the term “DMO®” and currently offers this plan. DMO® stands for Dental Maintenance Organization. This plan will cover basic coverage like cleanings and x-rays along with regular services like fillings, crowns, root canals, etc. Some services are not covered so review your insurance options.

The Dental DMO is known as a DHMO at most insurance companies.

DMO vs. PPO Dental Coverage

  • In a DMO® plan, you are forced to select a dentist from a specific list from your insurance company and indicate a primary dentist. With a PPO you can visit almost any licensed dentist.
  • A DMO® plan is like a discount plan. The insurance company contracts with a dentist and the rate you pay a dentist is indicated by a % of coverage. For example, your coverage may state you pay 50% of the service fees for dental work. With a PPO, you may also see coverage which indicates you pay 50% of the fees. The difference is that with the DMO® plan you pay 50% of the Dentist’s listed fees vs. with the PPO you pay 50% of the insurance company’s contracted fees. The Dentist’s fees will almost always be higher. You pay a % of a higher price.
  • DMO ®plan monthly fees may be lower than PPO monthly fees, making the plan to seem like it has the same (or better) benefits and less cost per month if you don’t read the details.
  • DMO® will not have a deductible.
  • Referrals required.
  • If a service is not covered under the DMO® plan, there is no contracted discount on that service. Dentists who associate themselves with a particular PPO can offer discounted rates on services that are not covered under insurance.
  • Co-pay may be required depending on you plan. Aetna’s PPO does not require a co-pay.


Choosing A Dental Plan

Next year when I renew my dental insurance I will pay the extra money for the PPO plan. I wish I had done my research and didn't on the information provided by my employer to make my choice in dental care and insurance.

Are you having trouble deciding which insurance plan is right for your and your family? Call your dentist and ask their opinion and to quote a few comparable rates based on the plan type you seek. Your dentist (we hope) wants to give you the best care and most information and keep you as a patient.

Do your research on your dentist as well as your insurance company. Find out your Dentist's reputation and billing rates with the links to the right. They will help you choose the right plan for your family.

Comments

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    • profile image

      Rose Marie Strauss 

      3 years ago

      Unfortunately I decided for a different Plan Cigna #305 from the retirement plan with the help of the Dental office. I was scheduled for a cleaning after they talked me into doing my gums first 2014.I had an appointment when she called me into a room and told me they they do not accept this card.

      I should have done my research before signing off on receiving another Insurance.

    • profile image

      Briana 

      5 years ago

      Thanks for this! I was selecting our dental plan for next year and almost chose the DMO instead of PPO (which we had this year) thinking it would be less expensive with the same/better coverage. After realizing that neither our pediatric dentist or regular dentist would be covered on the DMO I did a quick search and came up with this article- realizing that with the DMO you pay a percentage of the listed fees as opposed to contracted fees was the clincher for me in deciding to stick with our PPO! Thanks again for this article- our insurance's website didn't make the distinctions clear.

    • Doodlehead profile image

      Doodlehead 

      7 years ago from Northern California

      My only comment (since I do sell these plans) is that all plans are all different! I've never found an ideal dental plan...one that makes everyone happy. Problem on the PPOS usually is the limit on the maximum annual benefit.

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