There are two major types of managed care dental plans: Preferred Provider Organizations (PPOs) and Health Maintenance Organizations (HMOs).

Under the PPO model, a covered individual selects a dentist from a network of dentists who have agreed by contract to discount their fees in order to increase their business. If the covered individual decides not to use a network dentist, he or she can go outside the network and pay the dentist’s usual fee for service. Thus, the plan benefits would be reduced for going out of network.

An HMO that offers dental care requires the covered individual to be assigned a primary care dentist who receives a monthly fee per assigned enrollee from the plan to be part of the network. The covered individual gets basic preventive, diagnostic and minor dental care at no charge and other services at a highly discounted fee.

HMO plans will not reimburse for any services obtained from a non-network dentist unless there is a Point of Service agreement. Similar to the HMO model is a Pre-Paid Limited Health Service Organization (PLHSO) or pre-paid dental plan.

Most managed care plans are offered by employers and many of these plans allow for voluntary enrollment.