A Dental Health Maintenance Organization (DHMO) plan can also be called a capitated or pre-paid plan in some states. You will be required to choose one dentist or dental facility from which to receive all of your dental care. This dentist is called your primary care dentist. If you need to see a specialist, your primary care dentist will refer you.
Each time you receive a dental treatment, you pay a fixed dollar amount, or “co-payment.” Most diagnostic and preventive services, such as cleaning and some x-rays, have no copayment, so these services will be free.
DHMO plans do not usually have deductibles or maximums. Dentists in the network have gone through a rigorous credentialing process to be considered for participation.
If you visit a dentist other than your assigned primary care dentist, you will have to pay for the full cost of treatment. Specialty care that you are referred for may require preauthorization.
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