Sunday, April 14, 2024

Ameritas Dental And Vision Insurance

What Ohip Covers And What It Doesnt

How to Choose an Ameritas Individual Dental and Vision Plan

Before you can decide whether or not you need supplementary health and dental insurance, you should have an idea about the kinds of services OHIP does and doesnt pay for. The basic expenses covered by OHIP include:

  • Visits to doctors

For a full list visit What OHIP Covers.

What OHIP doesnt typically cover:

  • Prescription drugs/medicines provided outside of hospitals such as antibiotics, painkillers, and some cancer drugs
  • Specified elective medical services such as chiropractors or massage therapists
  • Semi-private or private hospital rooms
  • Some medical exams, tests and vaccinations

Ameritas Dental Plans For Seniors

Customers aged over 65 have an average discount of 31% when using Ameritas dental plans, with a 41% network utilization. Older members do not have to worry about enrollment fees, and have the same benefits as younger customers.

However, over 40% of American seniors currently have no dental insurance, despite the average dental bill of $1,154 each year. The main benefits of dental plans center around the preservation of your natural teeth, with cleaning, protective treatment, and fillings to prevent the need for dentures.

Approximately 8.3% of women and 6.9% of men aged 65 and over had unmet needs for dental care due to cost

You do not have to worry about unexpected health care costs if you are semi-retired, work part-time, or are a contractor. Through individual insurance, you can gain dental and vision benefits instantly, without having to search for them on your own. If youre moving, you can also keep your benefits when the location of your workplace changes.

Being employed, but not eligible for employer-sponsored coverage can still grant you access to Ameritas dental benefits. Additionally, you can still receive coverage through individual dental insurance if you are retired or self-employed.

Silver And Gold Plans

Silver and Gold plans provide more coverage, at 100% for preventive care such as cleaning and sealants, as long as you choose an in-network dentist. Instead of a percentage covered, they provide Maximum Covered Expenses for basic and major procedures. Basic procedures include fillings and extractions, while major services include root canal procedures and crowns.

An example of Silver level coverage for basic procedures is $75 for a one-surface resin composite filling. For crowns, one of the major services covered by your benefits, you can expect that $335 of your expenses will be reimbursed. Major procedures, however, have a six-month waiting period. Gold level dental coverage is slightly higher, with a larger maximum.

If youre looking for family coverage, some Ameritas dental plans will reimburse you for childrens orthodontic care. This is only available under Gold level plans for children under the age of 17, and carries a lifetime maximum instead of an annual limit.

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Reasons To Choose Ameritas

  • Innovative benefits that help you stand out
  • Combine dental and vision into one plan thats easy to administer and flexible to use with the option to bundle laser vision correction and hearing care.
  • Offer two vision plans, giving employees the choice between a VSP or EyeMed network plan.
  • Support employee retention and reward longtenured employees with benefits that increase over time.
  • Provide student loan repayment thats compatible with 401k and 403b retirement plans.
  • Exceptional network quality and savings
  • The Ameritas Dental Network is one of the largest in the nation with over 130,000 providers in the U.S. and Mexico. Network dentists charge members 25-50% below average for their region.
  • Our turnover rate has stayed at 3% or less for more than a decade. This means increased reliability and security for members.
  • Tools to make your job easier
  • Videos, websites and material support enrollment and benefits communication all year long.
  • Use your benefits administrator portal to quickly perform administrative functions in real time.
  • API interfaces quickly process benefit administration and enrollment functions.
  • Customer satisfaction and persistency
  • Spanish and multilingual interpretation services are available, with call centers located in the United States.
  • Customer Connections associates have earned BenchmarkPortals Center of Excellence award since 2006 and our utilization review process has been URAC Accredited since 2008.
  • Choosing A Dental Provider


    What is an in-network dental provider? An in-network dental provider participates on the Ameritas dental PPO network. Ameritas plan members can choose from more than 170,000 PPO provider access points nationwide for dental care. Use our online provider directory to find an in-network dental provider.

    How do I benefit when I visit an in-network dental provider? You may benefit from greater out-of-pocket savings when you visit a dental provider on the Ameritas dental PPO network.

    Can I see any dental provider or am I required to choose one from your PPO list?You are always free to visit any dental provider you choose. However, you may benefit from greater out-of-pocket savings when you visit a dental provider on our PPO network. For a description of your plan or to find out if you have PPO access, sign into your secure member account at and review your Dental Benefit Summary or certificate. If you have any questions about your choice of dental provider and how it may impact benefits, contact us at 800-487-5553 or .

    How do I know if my dental provider is part of the PPO network? Search for your dental provider in the Find a Provider directory on this website. If you have additional questions about your dental providers status on the Ameritas PPO network, contact us at 800-487-5553 or .

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    How To Increase Your Annual Maximum Benefit

    All three plans have an annual maximum benefit. If you reach this annual maximum benefit, Ameritas will not reimburse any additional services for the remainder of the calendar year. However, your Ameritas benefits include Dental Rewards.

    Dental plan members who have at least one covered dental claim filed in the previous calendar year and have less than $500 in claims payments, will be able to carry over $250 of their unused annual maximum for future use. This Dental Rewards accumulation can continue to grow each year if the member continues to have at least one covered service per year and paid claims in that year do not exceed $500. The Dental Rewards carryover is in addition to the annual maximum available under each dental plan option. If a member has a year when they have allowed dental services to go above their annual maximum, Ameritas will automatically pull from any Dental Rewards carryover that the member has accumulated.

    NOTE: The Dental Rewards dollars cannot be applied to Orthodontia benefits.

    Ameritas Dental Insurance: Is It The Right Choice For You

    • Posted on 24/09/2022

    Ameritas is one of the largest dental and vision insurance companies in the United States, with over 4 million customers, offering services for individuals, businesses, families, and seniors.

    But is Ameritas dental insurance right for you? In this article, we are reviewing Ameritas dental plans to see how much they cost, what they cover, and more.

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    How Much Does Ameritas Dental Insurance Cost

    The cost of dental insurance plans from Ameritas, like other companies, varies by location and type of plan.

    For example, a search on a third-party site for a 30-year-old woman living in Broward County, Florida reveals a $48.34 monthly premium if she purchases the Silver Fusion Hybrid Plan. As a PPO dental insurance plan, this is more expensive than a DHMO, in exchange for greater freedom of choice. This is also comparable to other PPO plans of the same level.

    The Gold FUSION Hybrid Plan costs $60.00 per month for individual dental insurance. This has the highest annual maximum, at $2,000. Her monthly premium for the Platinum FUSION Hybrid Plan is marginally lower at $59.53, with an annual maximum of $1,500.

    As for the Value FUSION Hybrid Plan, she can expect to pay $21.81 per month for individual dental insurance. This has a lower annual maximum, at $1,000 per person.

    A search on the Ameritas MyPlan tool for the zip code 11102 in Astoria, NY reveals a PrimeStar Protect Network plan with a monthly premium of $57.68. With this plan, you have an annual maximum of $1,200 per year after a deductible of $50. You receive two cleanings and examinations each year at 100% coverage, plus 50% coverage for basic and major procedures.

    After one year, basic coverage increases to 80%. There is also a one-year waiting period for childrens orthodontic care. If you would like to add vision insurance, you pay an extra $10.67 per month.

    Billing And Premium Payments

    Getting to Know Ameritas Dental, Vision and Hearing

    Are my rates guaranteed? Your rates are guaranteed for 12 months following your plans effective date. After that, you will receive at least 30 days notice if your rates change.

    How often can I make premium payments? When applying for coverage you can choose to make your premium payments monthly, quarterly, semi-annually or annually.

    What payment methods can I use to make premium payments? You can make premium payments by credit card, EFT or check. There is an $8 administrative fee applied each time you pay your premium by check.

    Which credit cards do you accept for premium payment? We accept Visa, MasterCard, American Express and Discover.

    When should I expect to be billed for the premium if Im paying by credit card? Youll see the first billing for your premium when your application is approved. After that, the premium amount will be billed on the first business day of the month for each month of coverage. If you select quarterly, semi-annual or annual premium payments, the premium will be billed on the first business day of the selected period.

    What is EFT ? EFT is a payment method where premium payments are automatically drafted from your checking or savings account on a regular basis. Monthly EFT payments are typically drafted on the first business day of the month.

    If I want to pay by check will I receive a billing statement? Yes, youll receive a billing statement. Send your premium payment prior to the due date to ensure there is no lapse in your coverage.

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    Late Entrant Restrictions On Benefits For 2023

    If you and/or your dependent are not currently enrolled for dental coverage through Duke and enroll for 2023, you and/or your dependent will be considered a late entrant. As a late entrant your benefits during 2023 will be limited to preventive services: two preventive routine care exams , two prophylaxis cleanings, and for children under age 19, one fluoride application. No other dental or orthodontia procedures or services will be covered during the first 12 months if a member is enrolled as a late entrant.

    Once you have been enrolled in a Duke dental plan for at least 12 months, the plan will also cover basic and major procedures such as fillings, extractions, crowns, root canals and periodontal treatment .

    Periodontal procedures, including maintenance/ cleanings, would not be covered during this 12-month period. This 12-month waiting period does not apply:

    • if you are switching from one Duke dental plan to another Duke dental plan,
    • if you enroll an eligible dependent within 30 days of a qualifying event such as marriage or adoption, or
    • if you add a child during an open enrollment period prior to his/her second birthday.

    Find Affordable Dental Plans With Ehealth A Trusted Partner Of Ameritas

    Ameritas is one of the largest dental and vision insurance companies in the United States, providing dental and vision service to more than 8 million people nationwide. Ameritas allows you to stretch your money even further by taking advantage of the more than 425,000 participating providers in network with deep discounts and rewards. Ameritas is rated A for financial strength and operating performance by A.M. Best Company.

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    Questions To Ask: Making Your Dental Plan Decisions

    When comparing Duke’s dental plans, it is important to compare out-of-pocket expenses as well as premiums. Here are some questions to ask yourself when choosing a dental plan that matches the needs of you and your family. For specific coverage information, please refer to the Dental Plans Comparison Chart.

    Is a Pre-Treatment required? We strongly suggest you ask your provider to submit a pre-treatment prior to expensive procedures such as crowns, bridges, root canals, etc. We strongly suggest you ask your provider to submit a pre-treatment prior to expensive procedures such as crowns, bridges, root canals, etc. We strongly suggest you ask your provider to submit a pre-treatment prior to expensive procedures such as crowns, bridges, root canals, etc.

    Ameritas Dental Insurance Providers

    Ameritas Dental Insurance Policy Review  Independent Health Agents

    Ameritas has one of the largest dental insurance networks in the United States, with over 557,000 access points nationwide. As a PPO, you are able to see any dentist you want, but you save more when sticking to the network.

    Dental plans by Ameritas have no waiting period for basic and preventive services, with coverage beginning the next day. Preventive care, including checkups and cleanings, is 100% covered too as long as you see an in-network dentist. Even better, there are no enrollment fees to create extra expenses.

    Altogether, these factors make Ameritas dental insurance perfect when you need coverage fast.

    You can search for clinics that support Ameritas dental coverage through their website, and pin three at a time to compare their costs. The most cost-effective providers are highlighted in green. All listings include clinics names, addresses, telephone numbers, opening hours, and whether or not they accept new patients.

    For example, a search for Broward County, Florida yields 5,416 providers in the Classic PPO Network, and 1,622 providers for the Value plans. On the other hand, searching for dental coverage in Portland, Oregon, only yields 62 providers. The largest clinic is Emergency Dental Downtown PC, with a number of general dentists, as well as an endodontist and orthodontist.

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    Customer And Provider Retention

    In 2021, Ameritas Mutual Holding Company remained one of the largest health insurance companies in the United States. A total of 8 million Americans held dental and vision insurance by Ameritas, alongside other insurance plans.

    The Ameritas network of dentists has a low turnover rate, at no more than 3% for over a decade. This means that your dentist has an over 97% chance of staying in the network during the next year, so the level of benefits you can receive remains the same. Changes to patient circumstances do not necessarily affect coverage, as Ameritas aims to retain customers.

    What is Ameritas dental insurance, and how can potential members learn more?

    Dental And Vision Insurance:

    There are several benefits to having both dental and vision insurance. These policies will help you maintain a clear smile and keep your eyes healthy. Indemnity plans are another great way to save money on your vision and dental bills. These plans do not require network memberships, and they will pay a percentage of the costs of covered services. Indemnity plans will also let you choose your own dentist or optometrist.

    Some health insurance plans offer both dental and vision coverage as part of their plan. You may find the best value in a dental/vision plan by using the Find a Plan page. This tool will help you find the right plan for your family and your budget. Then you can learn more about each one and decide if you want to continue with it later. You can also see how much each policy costs and what services are covered.

    Stand-alone dental plans are popular for individuals and families. These policies typically provide 98 percent of the benefits of a group plan. While youll have to pay a separate monthly premium for each policy, this type of plan gives you more flexibility and coverage. You can cancel the policy anytime throughout the year, which is useful if you change your mind or your family size. Youll also have more control over when to use it and what it covers.

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    What Is Ameritas Dental Insurance

    Ameritas dental insurance is part of the Ameritas Mutual Holding Company. Dating back to the 19th century, Ameritas has offered both dental and vision insurance with high ratings for its services. Ameritas Mutual Holding Company has earned an A rating from AM Best, which evaluates insurers financial strength, and an A+ from Standard and Poors.

    All Ameritas dental health insurance plans have a PPO structure, meaning you can choose any dentist you want, but save more when you stick to the network. To learn more about PPO dental insurance, and how it differs from the dental HMO structure, read this article on the two most common types of dental insurance.

    Your level of coverage depends on the type of plan you purchase.

    Bundle Your Dental Insurance With A Vision Plan

    Ameritas PrimeStar Individual Dental and Vision Insurance

    So, lets say, youre already a member of Spirit Dental. The three annual cleanings and dental education have vastly improved your oral health and smile. Theres just one problem: you cant enjoy seeing the dental work from too far away because of poor vision. Did you know, according to a recent National Health Interview Survey, 23.7 million American adults age 18 and older reported experiencing vision loss?**

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    Preferred Provider Option Plan

    The PPO plan includes a higher maximum annual benefit than Plan A and Plan B, lower negotiated procedure rates, and your out-of- pocket costs are usually lower. However, members in the PPO plan will need to select an in-network provider. If you select the PPO plan and use an out-of-network provider, the amount the plan pays will be based on discounted network charges and you will be responsible for any amount charged over that allowance. A list of network dentists is available at the Ameritas website or by calling Ameritas at 1-800-487-5553. When searching for an Ameritas network provider, select the Classic Network.

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