|
Features |
First Dental Plans |
Other Plans |
| Can the plan deny part of the billed charge or
pay less than the Dentist's charges? |
No. Dental Charges are never adjusted. Plan always
pays based on the reimbursement Schedule. |
Yes. Plans can deny or reduce dentist's charges
and often do! |
| What are the exclusions? |
Cosmetic Dentistry (tooth whitening), Implants
and TMJ |
Typically a full page of exclusions and limitations
to the plan. |
| Is there a limitation on the number of cleanings
allowed per year? |
No. Our schedule is for any covered dental procedure.
You can have as many cleanings in a year as you want. |
Yes. Typically only two cleanings a year, and
at least 6 months apart. |
| Orthodontia for Children included? |
Yes. Under age 19. Treatment as any other procedure. |
Sometimes, and often an optional benefit at inflated
prices. |
| Lifetime Maximum on Orthodontia? |
2 times the maximum elected. |
At best, the same as the annual maximum of the
elected plan - often less. |
| Are sealants covered? |
Yes. Treated as any other procedure. |
Sometimes. Must meet strict guidelines and are
often denied. |
| Is any preauthorization required before dental
treatment? |
No |
Yes |
| Can you go to any licensed dentist in the US? |
Yes |
Only with "indemnity" plans. Often
must use a non-receptive network. |
| Can out-of-state employees be covered? |
Yes |
Sometimes |
| Are voluntary plans allowed? |
Yes, with reasonable participation requirements. |
Sometimes |
Plan $750 Example:
Plan Coverage: 0% of the first $50, 80% of the next $250,
50% of the next $1100 for an annual maximum benefit of $750 per
person.
|
Dental Expense |
First Dental Share |
Employee
Share: |
Paid Benefit |
Employee
Out-of Pocket |
 |
|
$50.00 |
0% |
100% |
$0.00 |
$50.00 |
|
$250.00 |
80% |
20% |
$200.00 |
$50.00 |
|
$1100.00 |
50% |
50% |
$550.00 |
$550.00 |
 |
|
$1400.00 |
Totals: |
|
$750.00 |
$650.00 |
Estimated Monthly Premiums based on Voluntary Employee
Participation, Area A, Rating, 75% participation and groups over
51. Quotes will vary and may be lower! Please Request
a Proposal:
Employee = $11.91
Employee + 1 = $22.96
Employee + 2 or more = $35.35
Other First Dental Plans include Plan $2000, $1000
and $500 annual maximum plans.
* Some waiting periods may apply for 6 months for
persons without prior coverage. Contact
Us for more details.
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