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Dental insurance can help cover the cost of many dental procedures and treatments. However, there are several policy types that can offer different advantages to policyholders. Two of the most common are Preferred Provider Organizations (PPOs) and Health Maintenance Organizations (HMOs). Each plan usually differs in features, benefits, coverage, and average costs. This article will help explore how PPO dental insurance works and how it compares to HMO plans so that you can select the best type of plan for your needs.
Table of Contents
A dental PPO plan is a type of dental insurance that offers a network of dentists who can provide policyholders with services at rates negotiated with the insurer. Members can visit any dentist within or outside the network, however, costs can be lower for in-network providers.
Here are the primary benefits of PPO dental plans:1
PPO plans tend to offer more extensive provider networks. This gives you more options for seeking affordable dental treatments.
PPO dental plans don’t limit you to in-network providers. If you have a preferred provider who is not in-network, they can still provide services. However, keep in mind that reimbursement percentages may vary for out-of-network providers, resulting in higher costs.
PPO policyholders don’t need to visit their primary care dentist to get a referral for a specialist. This could save you time and offer extra convenience, helping you resolve issues more quickly.
If you go out-of-network and a provider charges more than the PPO’s set rate for a service, you’ll usually have to pay the difference. However, you could potentially receive reimbursement for some of the cost.
Don’t wait until it’s too late. Help cover yourself and your family with coverage from Aflac.
Get StartedHere are some key differences between dental PPO and HMO plans:
| PPO | HMO | |
|---|---|---|
| In-network coverage | Large network | Smaller network |
| Out-of-network coverage | Yes | Limited to emergency services under specific circumstances1 |
| Cost | Higher premiums | Lower premiums1 |
| Deductible | Higher | Usually none, but lower if they exist1 |
| Annual maximum | Yes1 | No |
| Co-pays | Can be higher | Generally lower than other plans1 |
Here are a few factors to consider when deciding if a PPO dental insurance plan is the right choice for you:
PPOs can work well if you want additional flexibility when seeking your primary dental provider. For example, if you prefer a particular provider outside the network, a dental PPO plan will allow them to provide services. They may partially reimburse certain services as well. Otherwise, finding an HMO plan for that provider may be best if you plan to stick to one in-network provider.
If you believe you’ll need to visit specialists, a PPO may be the best option. You won’t have to schedule an appointment with your primary dentist to get a referral, helping you save time and making it easier to get the specialized care you need. However, if you don’t anticipate much care beyond regular check-ups and minor services, you may opt for an HMO.
PPOs tend to charge higher premiums for the extra benefits and more extensive network. So, this type of plan can make sense if you’re willing to budget more for dental insurance. However, if you don’t believe you’ll need the extra benefits a PPO offers, an HMO can help you potentially bring down your coverage costs.
PPOs can offer a larger network, increased flexibility, and more convenience than HMOs. However, HMOs typically charge lower premiums and only have co-pays rather than deductibles. Ultimately, weigh your budget against the features of PPOs to see if this type of plan is right for you.
Aflac’s dental insurance can help offer enhanced insurance coverage for a variety of dental procedures. Start chatting with an agent today to help explore your dental coverage options and get a quote.
Get Started
Wondering if dental insurance is worth it? Learn about how dental insurance works, coverage options, and how to get the right plan for you.
Affordable dental insurance is possible. Aflac walks through the average dental insurance costs and discusses your low-cost dental insurance options.
Wondering if dental insurance is worth it? Learn about how dental insurance works, coverage options, and how to get the right plan for you.
Affordable dental insurance is possible. Aflac walks through the average dental insurance costs and discusses your low-cost dental insurance options.
1 Investopedia - Dental Insurance HMO vs. PPO: What’s the Difference? Updated February 26, 2024. https://www.investopedia.com/dental-insurance-hmo-vs-ppo-whats-the-difference-8553452. Accessed March 25, 2025.
Content within this article is provided for general informational purposes and is not provided as tax, legal, health, or financial advice for any person or for any specific situation. Employers, employees, and other individuals should contact their own advisers about their situations. For complete details, including availability and costs of Aflac insurance, please contact your local Aflac agent.
Aflac coverage is underwritten by American Family Life Assurance Company of Columbus. In New York, Aflac coverage is underwritten by American Family Life Assurance Company of New York.
Dental: In Delaware, Policies A82100R–A82400R. In Idaho, Policies A82100RID–A82400RID. In Oklahoma, Policies A82100ROK–A82400ROK. In Virginia, Policies A82100RVA–A82400RVA.
Dental, Vision, and Hearing coverage is underwritten by Tier One Insurance Company. Tier One Insurance Company is part of the Aflac family of insurers. In California, Tier One Insurance Company does business as Tier One Life Insurance Company (NAIC 92908).
Dental, Vision and Hearing: In Delaware, Policy T80000. In Idaho, Policy T80000ID. In Oklahoma, Policy T80000OK. Dental claims are administered by SKYGEN USA, LLC. Vision claims are administered by EyeMed Vision Care, LLC. Hearing claims are administered by Nations Hearing. NOTICE: The coverage offered is not a qualified health plan (QHP) under the Patient Protection and Affordable Care Act (ACA) and is not required to satisfy essential health benefits mandates of the ACA. The coverage provides limited benefits.
Coverage may not be available in all states, including but not limited to NJ, NM, NY, VA or VT. Benefits/premium rates may vary based on state and plan levels. Optional riders may be available at an additional cost. Policies and riders may also contain a waiting period. Refer to the exact policy and rider forms for benefit details, definitions, limitations and exclusions.
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