Who are these services for?
Anyone with little or no existing dental coverage.
What services are covered?
Everything you would expect out of a dental plan, including:
- Preventive & Diagnostic Services – Examinations, cleanings, x-rays, & tests and labs
- Basic Services – Simple Extractions, fillings, endodontics, anesthesia
- Major Services – Prosthetics, restorations, and oral surgery up to an annual maximum of $2,000 in services.
For full details, check out the Tier I Benefits Summary
Which services are not covered?
The following services are not covered:
- Cosmetic surgery and treatment unless it is reconstructive surgery caused by trauma, infection, or disease of the involved part.
- Prescription drugs and medicines.
- Services and appliances for the treatment of temporomandibular joint (TMJ) dysfunction. iv. Transplantations.
Is there a deductible I have to hit before the health insurance starts paying?
There is a $0 deductible meaning you don’t have to pay anything before the coverage we provide kicks in!
Are there copays or co-insurance?
No. So long as you see an in-network dentist, the plan covers the full expense of all covered services.
What dentists can I see?
You can see any dentist you like with one caveat: As a Preferred Premier Dental Plan, you have access to a network of more than 10,000 dentists and specialists in New York and New Jersey. While you can visit either an in-network or out-of-network dentist, when you visit an in-network dentist, you can be certain that the insurance we provide you with will cover 100% of the set dollar amount for the service or 100% of the bill (depending on the service). When you see an out-of-network dentist, the health insurance provider will pay the full amount they’d pay to an in-network dentist but if your out-of-network dentist charges more than that, you’ll have to pay the difference. Search for an in-network dentist by specialty in your area.