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VantagePointe Benefit Solutions
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Marshall, MI 49068
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Dental

Preventive: These benefits consist of cleanings, X-rays, etc.  These benefits are usually covered at 100% depending on the plan design.  Please see your benefits guide for specifics to your carrier's plan.

 

Basic Coverage: These benefits consist of simple fillings, extractions. Please see your benefits guide for specifics to your carrier's plan. These services are usually covered from 75-80% depending on the plan design.

 

 

Major: These benefits consist of Root Canals, Crowns and Bridges.

 

 

Orthodontia: These benefits consist of braces. Age limits for these services are usually 19.

 

 

Dental plans usually have the following components:

 

 

Deductibles: The number of covered expenses that the insured must pay before the plan or insurance contract starts to pay claims for covered benefits.

 

 

: Most policies require the insured to pay some portion of the bills. A typical arrangement is after the deductible is meant that the insurer pays a portion and the insured pays a portion depending on the class of services up to a set maximum for example of covered expenses. After the maximum out of pocket limit is met the insurer pays 100% for covered services for the remainder of that calendar year up to the benefit amount or lifetime maximum.

 

 

Plan Maximums: These can vary from $750 per person to $2500 per person depending on the coverage.

 

 

Dental Coverage can be any of the following:

 

 

Indemnity: The insurance company will pay the provider and there is no network you must go through. Most costly coverage because of no network.

 

 

Passive PPO: You receive more of a discount if you go to an in-network provider but is not required. It will pay like an indemnity plan but the reimbursement may be a little less.

 

 

PPO: You must go to an in-network provider to receive the in-network benefits to avoid less coverage.

 

 

Individuals can purchase this coverage but few carriers sell individual products.

 

 

 

Contact us to learn more