What is an HMO Dental Insurance?
HMO Dental Insurance Plan is a plan that forces its members to see only in-network dentists. Most HMO plans (also known as DMO) work on a capitation basis. That means that the plan pays the dentist a certain amount per member every month, whether or not the member sees the dentist. However, when the patient does come, the dentist is not allowed to charge the patient or the insurance anything for many procedures, and a very minimal co-pay for the rest. The participating dentist hopes that the monthly check will cover any procedures the patient may need. Unfortunately, this arrangement creates a very complicated situation. The dentist receivesvf the monthly check for all members, some of whom he will never see. In fact, he hopes that he doesn’t see many patients on his list – because when a patient does come, the dentist is basically working for free. As a result, many HMO patients find it difficult to make appointments at participating dentists, because the dentists severely limit appoi