As a City of Fort Worth employee, you have three dental plan options available to you: the Dental Preferred Provider Organization (DPPO) option with a high and low plan choice, and the Dental Health Maintenance Organization (DHMO) option. Both plans have limited networks and are limited to those residing in certain ZIP codes.
The DHMO option offers a more cost-conscious option with copays for most services. You must elect a primary care dentist with this plan, and that dentist will direct your care and refer you to other types of dentists as needed.
The DHMO option provides fixed copays for all levels of services, provided you have received a referral to a network specialty dentist and the treatment plan has been authorized for payment.
The DPPO options (high and low) offer you more freedom of choice for dentists, offering in- and out-of-network coverage, but there is a limit to how much the dental insurance will pay for services like cleanings and X-rays. A primary care dentist is not necessary, and covered treatments are paid out on a coinsurance basis.
The DPPO high option offers a higher annual maximum and higher levels of coinsurance. It also covers implants, and orthodontia is covered for children up to age 19 and adults.
Orthodontics are also covered on the low DPPO option now, and implants are covered on both options too, up to the plan limit. Both high and low DPPO plan options allow you to receive four cleanings per calendar year.