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Aging What Can We Do About It?
We all want to live a healthy, active life well into our later years. Science has come up with a lot of helpful information to help us live longer and have a more quality life. Choosing the right nutriants can help slow down the aging process...
Do You Believe the Earth is Flat?
Because I am an outspoken practitioner of lifelong agelessness, on occasion, a proud possessor of a negative mindset accosts me with this provocative question: “Why bother trying Put Old on Hold? Everybody gets old. Just go with the flow.” Go with...
Ten Ways to Get the Most Out of an AA Meeting
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The Business Traveler’s Diet Problem: Staying Fit When on the Run
Despite the fact that accurate nutrition information can be accessed by almost anyone with an Internet connection or a library card, the 21st century has picked up where the last one left off: one dominated by poor eating habits. The reason for...
The Truth About Getting A Tummy Tuck
Are you sick and tired of your flabby belly? A tummy tuck might
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What is the difference between HMO and PPO dental plans?
You can re-publish this article as long as you provide clickable links to the source. A courtesey email to marketing@dentistry21.com will be appreciated.
What is the difference between HMO and PPO dental plans?
If your employer offers dental benefit or if you are shopping for it yourself you often come across two terms:
1. Dental HMO plans (DMO)
2. Dental PPO plans
To be able to make a correct decision you should know the difference between the two, and I don't mean the coverage difference that is usually presented by the insurance companies. What I mean is the real difference.
You should know how they pay the doctors and which plans the doctors favor. Why? Because eventually it is the dentist that will provide the service to you and not the insurance company. So, no matter what the insurance company claims their doctors have to do, your dentist will treat you as he or she sees fit.
To look at the issue from the perspective of a dentist, let's see how they differ in terms of payments to the doctors.
1. The PPO plans
PPO plans, also called preferred provider plans, pay doctors based on the procedures they perform. In other words, for each approved treatment or service performed by your dentist the insurance company sends him a payment (assuming other limitations don't apply). When you are talking about this kind of coverage, it means the more your doctor does the more he is paid. Of course there are checks and balances in place to make sure the doctors overall performance is acceptable.
2. HMO plans
When it comes to a general dentist,
usually the way the insurance companies pay is called capitation payment. Which means they sign a contract with a doctor for a certain number of people (let's say 500 people). Then they pay doctors a monthly payment for each patient (Something around 1-6 dollars per person). Then in return they expect the dentists to perform certain procedures for free and some others at a discounted rate.
When you think about it, you realize practically they reward doctors who do less! As far as the dentists are concerned if they are performing a "covered benefit" they are losing money! The only time they make money is when they perform a procedure that is not covered by insurance.
Getting more familiar with the system, you now realize why some dental offices act strongly when you call them for appointments having an HMO plan.
The fact is that insurance companies (being a large monopoly dealing with a non-union crowd) have pressured many doctors (both in medicine and dentistry) to sing up with HMO plans. That has resulted in lowering of the quality of service across the country.
Next time you are thinking about selecting an insurance plan keep in mind the way they reimburse the doctors. You should not make your decision only based on the list of co-pays they give you. You may end up paying much more for a lower quality of service in the long run.
Go to http://dentistry21.com/public for more information.
About the Author
Dentistry21.com a comprehensive dental resource that contains dental plan information. You can compare and buy a dental plan that suits you.
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