1480 US Highway 395 N
Gardnerville , NV 89410

We do not accept Nevada medicaid.
We do not accept HMO Plans

(775) 392-3209
(775) 392-3209

Understanding Insurance

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(775) 392-3209

If you have Dental Insurance you’d like to use, here’s a side-by-side comparison of Dental HMO (DHMO) vs Dental PPO (DPPO) plans — how they work, their pros & cons, and things to watch out for. (Actual plan details can vary by insurer.)

Feature  Dental HMO (DHMO) Dental PPO (DPPO)
Premiums /
monthly cost		 Generally lower than PPOs, but limited coverage in the area and long wait times for appointments. Examples:  FCL and Delta Prominence. Possible higher cost for insurance, but more flexibility of providers & broader coverage.  You typically can go out of network and still get coverage. Examples: Aetna PPO, Humana PPO and Mutual of Omaha
Deductible Often no deductible (or minimal) for in-network services. Typically, a small deductible must be met before coverage kicks in for basic and major services ($50-$100 on average).
Copays/ Coinsurance  Fixed copay amounts for covered services (i.e. you pay a set fee when you receive the service).                  https://blog.solsticebenefits.com/solstice-member-blog/7-differences-between-dhmo-and-dppo?utm_source=chatgpt.com After the deductible (if any), you pay a percentage (coinsurance) of the allowed amount, or a fixed copay, depending on plan and service.
Network restrictions/
provider access 		 You must use dentists/specialists in the plan’s network. Out-of-network care is usually not covered. You can see in-network or out-of-network providers. In-network care is cheaper; out-of-network is usually partially covered.
Referrals/
primary dentist		 You must pick a primary care dentist (PCD). To see a specialist, you need a referral from your PCD. There’s usually no need to designate a primary dentist, and you can see specialists without a referral.
Annual maximum/
benefit cap 		 Many DHMO plans do not have an annual maximum (or have a very high one) for covered procedures. PPO plans almost always have an annual maximum benefit (e.g. $1,000–$2,000 or more) — once that’s reached, you pay full cost.
Waiting periods  Some DHMO plans may have little or no waiting periods for basic services, though major services might still be delayed. PPO plans may impose waiting periods for non-preventive or major procedures, but you may be able to have this waived (e.g. crowns, bridges).
Claim filing/
paperwork 		 Minimal or none — since you stay in the network, the dentist generally handles all billing. If you go out-of-network, we will take care of sending the claims for you.  Payments may go to the patient, but that is often not the case.
Best for/
typical use case 		 Good if you want lower cost and predictability, don’t mind limited provider choice, and mostly need routine/preventive care. Good if you value flexibility, want to keep your own dentist (even if out-of-network), or may need specialized care.
Risks/
trade-offs  		 Limited dentist options; no coverage (or very limited) out-of-network; you may have fewer choices in specialists. Higher costs (premium, coinsurance, deductible); once you hit the annual max, extra costs come out-of-pocket. Easier to get care locally.

Which one might be better for you? 

Here are some factors to consider when deciding between DHMO vs PPO: 

  • Your current dentist: If your preferred dentist is in-network for a DHMO, that makes DHMO more viable. If your dentist is out-of-network, a PPO might let you keep going there. 

  • How much dental work do you expect? If you’re mostly doing routine cleanings, exams, and minor work, a DHMO may suffice. But for more extensive work (crowns, implants, specialty care), the flexibility of PPO may be worth the extra cost. 

  • Cost sensitivity: If minimizing monthly premiums and predictable copays is your priority, DHMO tends to be cheaper and more predictable. 

  • Geographic / travel considerations: If you travel or move, PPO’s flexibility makes it easier to find dentists in different places.