Ethics & Law · single question

Which dental insurance plan structure allows patients to see both in-network and out-of-network providers, while offering lower costs for in-network care?

  1. Health Maintenance Organization (HMO)
  2. Preferred Provider Organization (PPO)
  3. Direct Reimbursement Plan
  4. Capitation plan
Show answer and explanation

Correct answer: B. Preferred Provider Organization (PPO)

A Preferred Provider Organization (PPO) is the most common type of dental insurance plan. It features a network of contracted dentists (preferred providers) who agree to discounted fee schedules. Patients have the flexibility to see both in-network (lower out-of-pocket costs) and out-of-network (higher costs) providers. An HMO (or capitation plan) restricts patients to a specific provider panel and requires a primary care dentist; out-of-network care is typically not covered. A direct reimbursement plan reimburses patients a percentage of their actual dental expenditure regardless of provider or treatment type, offering the greatest provider freedom.

Practice Ethics & Law questions Ethics & Law study notes

More Ethics & Law practice questions