HMO dental plans typically have a fairly narrow network; you can only use their providers to receive services. Though the networks are small, there are no waiting periods. It’s a scheduled-benefit structured plan. So in other words, you pay nothing or a copay to see the dentist whether it’s a cleaning or a procedure. For major procedures like root canals, the plan typically covers 50% of the cost. But again, there’s a schedule. Whatever the plan’s schedule it, that’s what you pay.
So, you can visit the dentist as often as needed; you simply pay the balance at the time of service. For instance, a root canal may be $800, but under your HMO dental plan, it will only cost you $450, which you pay while at the dentist. Another example: you schedule to get a crown, which costs, let’s say, $1,500; however, with the HMO dental plan’s schedule, it only costs $700. If you go outside of their network though, then you have to pay the total cost of $1,500. So within the network, you save a lot of money.
Since insurance is oftentimes overwhelmingly confusing, we want to shed light on this industry by answering YOUR questions. So if you have any questions or concerns, comment below and your question may be the topic of our next video!
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