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Group Dental Insurance

DHMO – Dental Health Maintenance Organization

and Prepaid Plans

Group Dental Insurance Photo

Looking for group dental insurance? A dental health maintenance organization (DHMO) is an organized system in which a network of highly qualified dentists, who receive fixed monthly fees, provides comprehensive and affordable care for individuals or families at a low monthly premium with services at either no cost or a reduced price. Some services may require a copayment. Features of a DHMO plan may include:

  • Each member selects a dentist or dental facility to coordinate all their oral health needs
  • Primary care dentist refers the member to a specialist (if needed)
  • Schedule of Benefits will determine the benefits for each covered service

DPPO – Dental Preferred Provider Organization

A preferred provider organization (sometimes referred to as a participating provider organization) is a managed care organization of medical doctors, hospitals, and other health care providers who have contracted with an insurer or a third-party administrator to provide health care at reduced rates to the insurer’s or administrator’s clients. Some of the benefits of a PPO are:

  • Members do not select a participating (in-network) dentist at enrollment
  • The DPPO plan design has two levels of benefits
    • In-Network
    • Out-of-Network
  • The member can go to any provider within the plan’s PPO directory of services
    • The member pays less when utilizing the participating providers directory for services
    • The member pays more when utilizing non-participating providers

Dental Indemnity/Fee-for-Service

Indemnity Plans are sometimes referred to as “traditional” dental insurance, and typically provide the most freedom in terms of choice of dentist, though usually with higher out-of-pocket payments. Indemnity plan providers make payments after receiving and reviewing the bill, and typically pay a percentage of the cost for a particular procedure based on a fee schedule.

Fee-For-Service Plans are similar to PPOs in that they provide an approved network of dentists, but they provide reimbursements for a specific amount based on a fee schedule. Fee schedule plans usually offer lower premiums than regular PPOs, but the patient is responsible for any costs incurred that go beyond the approved amount.

  • Members can visit any licensed dentist
  • Members may be required to pay the dentist up front then get reimbursed for eligible services

Vision Coverage

In most cases, vision insurance is a supplemental plan to your other types of health insurance policies. Vision insurance helps you offset the costs of regular eye examinations and will cover a portion of your expense for vision correction wear that is prescribed by your physician.

  • Eye examination and vision aids (glasses or contacts) are partially covered

Whether you need group dental insurance or vision care for your employees, give Amorosi Insurance a call. We can help you determine the best plan for you.