Dental & Vision Insurance
While the financial risks generally aren't as catastrophic as not carrying other types of insurance such as health or homeowner's insurance - many people find that having dental and vision insurance helps to spread out their costs for care into more manageable monthly premiums and co-insurance amounts. You may expect that if your dental needs are less than average, insurance may not save you money - but due to prenegotiated discounts, it may still benefit you (especially if you can find a network dentist.) The same thing would apply for vision insurance, if you wear glasses or contact lenses. Because you are paying your premiums whether you use it or not - it may also help to make sure you don't delay your routine check-ups and cleanings.
At this time, we have decided to use Ameritas as our provider for both dental and vision insurance. Ameritas has one of the largest dental networks in the country, with over 400,000 access points at over 100,000 unique providers. While savings will be greater if you are able to find a network provider, all of their plans are true PPO plans - meaning you can see any dentist you wish. For vision, they offer two plans, also with large, nationwide, networks.
We currently offer four main plans, with the Advantage Plus plans including two tiers of coverage. Premiums vary by zip code but the plan basics are the same.
The Advantage Plus and Advantage Plus Network plans have a $1000/year maximum benefit (this is at their discounted rates). Preventative services such as cleanings and bitewing X-Rays are covered at 100% with no deductible (assumes you use the "network" plan for an in-network dentist and the non-network for non-network dentists). The payment for non-network dentists is te 80th percentile of the local and usual customary charges. Additional services such as orthodontics, are covered after a $50 deductible, at 15% from day one and at 50% on January 1 of the next year (yes - if you enroll in December, you step up to 50% coverage the next month!). Keep in mind, your share of cost may be reduced further by renegotiated discounts if in your dentist is in Ameritas' network.
The Advantage Plus and Advantage Plus Network plans extend the maximum coverage to $2000/year and provide higher coverage for certain additional services. Fillings and simple extractions are covered at 50% on day one, stepping up to 80% on January 1. While other major services, including implants, dentures, and orthodontics are covered at 15% day one and 50% on January 1st.
GPM Dental 2500 and GPM Dental 2500 Network are very similar to the above but the overall coverage bumps up to $2500/year. Preventative services such as cleanings and bitewing X-Rays are covered at 100% with no deductible (again, this assumes you use the "network" plan for an in-network dentist and the non-network for non-network dentists). The payment for non-network dentists is the 80th percentile of the local and usual customary charges. Additional services, such as implants and oral surgery are covered after a $25 deductible, at 25% from day one and 50% on January 1 of the next year. Fillings, simple extractions and panoramic X-Rays are covered 50% on day one, 65% on January 1 and step up to 80% after 2 years. Neither of these plans offer orthodontic coverage.
You can see monthly premiums, search for providers and even sign-up online through one of the two links at the bottom of the page! The first link is for the Advantage Plan options and the second is for the GPM Plans (if you are not in California, please give our office a call before enrolling). Any provider shown in green will accept the network plans and offer the best discounted rates. Any providers shown in grey will accept the non-network plans for the best coverage (you can still see them with the network plan but depending on your needs, you'll generally have better coverage with the non-network plan). Any providers not listed can still be seen and will generally be covered better with the non-network plan.
Ameritas offers two vision plans - the Primestar Select and Choice plans. Prices are the same nationwide - $10.67/mo for an individual/$19.63/mo for a couple for the Select plan, and $16.34/$30.07/mo for the Choice plan. There are no waiting periods for full coverage to start.
The Select plan uses the EyeMed Vision Care Access Network - which you can search at www.eyemed.com. It has over 7,000 retail locations - including LensCrafters, Pearle Vision, Target Optical, JCPenney Optical, Sears Optical, and many independent providers. There are fixed co-pays for all services ($25 for an eye exam), and a $130 allowance every TWO years for glasses OR contacts. However, you have additional discounts beyond the initial coverage as well. If you choose to see an out of network provider - fixed allowances are provided for various services.
The Choice plan uses the VSP Choice network - which you can search at www.vsp.com. It includes all of the same providers as the EyeMed network, but also includes Costco Optical, and many additional independent providers. Co-pays are generally lower for most services, and the eyeglass/contact allowance is $150 EVERY year.
IF YOU HAVE ANY QUESTIONS WHATSOEVER, OR WOULD LIKE US TO HELP YOU DECIDE ON WHICH PLAN IS BEST FOR YOU - PLEASE LET US KNOW.
If you would like to get a quote yourself, you may do so below. (Again, if you are outside of California, while you can get a quote online, we ask that you please call our office before applying.)
Feel free to share this with any friends or family that need dental or vision insurance - the site is simply www.roloffdental.com