Dental Insurance and Vision Insurance
Vision Insurance is a form of insurance that provides coverage for the services rendered by eye care professionals such as ophthalmologists and optometrists. The typical vision insurance plan provides yearly coverage for eye examinations and partial or full coverage eyeglasses, sunglasses, and contact lenses, with or without co pays, depending on the plan chosen.
Dental Insurance is a type of health insurance designed to pay a portion of the costs associated with dental care. There are several different types of dental insurance - individual, family, or group dental insurance plans grouped into three primary categories: Indemnity (or sometimes called: true dental insurance ) which allows you to see any dentist you want who accepts insurance.
Preferred Provide Network dental plans (PPO; briefly discussed below), and Dental Health Managed Organizations (DHMO) in which you are assigned to an in-network dentist or in-network dental office and must stay within that network to receive your dental insurance benefits.
Generally dental offices have a fee schedule, or a list of prices for the dental services or procedures they offer. Dental insurance companies have similar fee schedules which is generally based on Usual and Customary dental services, an average of fees in your area. When a dentist signs a contract with a dental insurance company that provider agrees to match the insurance fee schedule and give their customers a reduced cost for services, this is considered an In-Network Provider or Participating Provider network (PPO). Depending on your specific plan, if you seek an Out-of-Network or Non-Participating Provider, any difference of fees will become the financial responsibility of the patient unless otherwise specified in your dental policy.Some dental insurance plans may have waiting period restrictions. This is a period of time before certain benefits will be covered. Often set in place when you are a new enrollee or seek out an independent plan outside of an employer or group.
Dental insurance plans may have an annual maximum benefit limit and after that maximum benefit additional treatments become the patient's responsibility. Each year that annual maximum is reissued. The reissued date may vary as a calendar year, company fiscal year, or date of enrollment based on your specific plan. Orthodontics usually has a separate limit. Some plans may have an annual deductible depending on the treatment rendered. After the deductible is met, the remaining fee is then paid at its specified percentage or fee schedule.
Dental insurance companies set services or procedures into categories and refer to them with American Dental Association (ADA) codes. As an example, Preventative and Diagnostic procedures often include exams, x-rays, and basic cleanings or prophylaxis. Basic procedures often include fillings, periodontics, endodontics, and oral surgery. Major procedures often are crowns, dentures, and implants. Procedures such as periodontics, endodontics, and oral surgery may fall into the Major category depending on your specific plan with specific fee schedules and co-payments. However, many dental insurance plans offer free semi-annual exams, x-rays, cleanings, fluoride, fillings, crowns, and dentures with various limitations such as cosmetic. The enrollment process varies but often members are assigned an identification or policy number. When dental treatment is rendered a claim for services is filed with the dental insurance company. Eligibility of Benefits, or EOB, statements are most often then sent with payment to both the provider of service and the plan policy holder.Good Dental Health can lead to better overall health.
Plans that can offer immediate coverage for major dental services including Bridges, Crowns, Dentures, Extractions, Implants, Root Canals and more!
Finding the right dental insurance plan with the right options can be complicated. Spirit Dental makes it easy by offering affordable insurance plans with guaranteed acceptance and no waiting periods.
No Waiting Periods
Implants & Major Services Covered
3 Cleanings per year
Our Dental PPO plan helps you pay for the dental care you need and gives you access to the Careington Maximum Care Dental Network.
Offers three different benefit levels to choose from, helping you find the plan that best fits your needs and budget
Helps you save an average of 40% on dental care when you visit network dentists
Doesn’t require a waiting period for preventive care — helping you get the coverage you need, right away
Provides network discounts on all services, including basic and major services needed during the plan’s waiting period
The plan DOES NOT meet the pediatric dental coverage level requirements as mandated by the Affordable Care Act
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Pays cash towards dental expenses
Dental Indemnity coverage from National General Accident & Health pays cash benefits when you have dental checkups and treatments, helping you catch small problems before they become big expenses. Add our Network Savings Card to your plan to save an average of 45% on dental care - on top of the cash benefits from this plan when you visit in-network providers.
Set benefits that pay for preventive care and covered treatments — available for you, your spouse and any dependent children
The option to add our Network Savings Card to help you save an average of 45% on dental care
No waiting period for preventive and basic services. Your benefits are available on your plan’s effective date
The plan DOES NOT meet the pediatric dental coverage level requirements as mandated by the Affordable Care Act.
Battistone Insurance Group
281- 391 3133