For the most part dental HMO’s insurance plans have fewer limitations then dental PPO’s and Indemnity insurance plans. Yet, they still have limitations that need to be carefully read and understood before buying.
One such limitation which many people may know is that you have to go to dentists that are providers of the plan. There are no benefits if you choose to go to a dentist that is not a provider of an HMO plan.
Generally under an HMO dental insurance plan, coverages are based on a fee schedule which shows the cost for all the different dental services that are covered under the plan. Yet the fee schedule that is provided is normally only for the general dentist you picked to be your provider. The fee schedule is normally not the benefits you receive if you need to be refer to a network specialist. This is important to understand, since HMO plans will either not cover for specialist or only provide saving of around 20 – 30 percent off network specialist depending on the plan.
Although HMO plans will not normally have a yearly dollar max limitation per person per year they may have limitation on how many of one dental service you can have. You may already know the two cleaning per person per year but many HMO’s insurance plans will only provide benefits up to four to five crowns per person per year.