Dental Insurance Basics: PPO, HMO and No Insurance
Updated 2026-11-02 · General information, not medical advice.
Dental insurance works differently from medical insurance. Knowing a few terms helps you avoid surprises.
Key terms
- Annual maximum: the most the plan pays per year, often modest; above it you pay.
- Deductible: what you pay before coverage starts on basic and major work.
- 100-80-50: a common pattern — preventive at 100%, basic (fillings) at 80%, major (crowns) at 50%.
- Waiting period: new plans may delay coverage for major work.
PPO vs. HMO (DHMO)
PPOs let you see any dentist but pay more when out-of-network. DHMOs have lower premiums but require an assigned network dentist.
No insurance?
Ask about in-house membership plans, dental savings plans, payment plans or community clinics. If eligible, NC Medicaid includes dental benefits — see our Medicaid guide.
This article is for general information only and does not replace advice from a licensed dentist or doctor.