Primary Plus
Plan Type | DPPO |
Coinsurance | N/A |
Deductible | Basic Services: $50 per person Major Service: N/A |
Annual Maximum Benefit | We pay up to: $1,000 per person, per calendar year |
Office Visit
Find Dentists |
N/A |
Primary Benefits | |
---|---|
Teeth Cleanings | 0% Coinsurance starting day one |
Restorative Dentistry/Fillings | 50% Coinsurance starting day one, 35% Coinsurance after policy year one, 20% Coinsurance after policy year two |
Oral Surgery | Not covered |
Extractions | 50% Coinsurance starting day one, 35% Coinsurance after policy year one, 20% Coinsurance after policy year two |
X-Rays | 0% Coinsurance starting day one (Bitewing - limited to 1 series per calendar year; Full mount panoramic - limited to 1 per 36 months) |
Crowns | Not covered |
Root Canals | Not covered |
Periodontics | Not covered |
Dentures | Not covered |
Topical Fluoride | 0% Coinsurance starting day one |
Sealant | 0% Coinsurance starting day one |
Bridges | Not covered |
Endodontics | Not covered |
Additional Information | |
A.M. Best Rating | A+ as of 12/14/2023 |
Electronic Signature for Application Available | Yes |
Details and documents about this plan | |
View Plan Brochure Exclusions and Limitations |
Important notices and disclaimers
- The information shown here is a summary of benefits for informational purposes only. Review the official plan documents (such as evidence of coverage, plan brochure, or insurance policy) for a detailed description of coverage benefits, limitations, and exclusions. Only the terms and conditions of coverage benefits listed in the policy are binding.
- The benefits listed may be contingent on your use of physicians, hospitals, dentists and services within the specific insurance company's provider network.
- The Copayment, Deductible, and Coinsurance amounts are your share of the costs for covered benefits. These amounts are subject to change.
- The quotes or rates shown above are estimates only. Your premium is subject to change based on your medical history (pursuant to state law of residence), the underwriting practices of the insurance company, the optional benefits you selected, if any, and other relevant factors, such as changes in rates which take effect before your requested effective date. The insurance company always determines your actual premium. Insurance companies reserve the right to change the terms of a policy upon proper notification.
Carrier specific notices, disclaimers and fees
- UnitedHealthcare - Golden Rule Insurance Company, a UnitedHealthcare company, is the underwriter of these plans. This product is administered by Dental Benefit Providers, Inc.
- UnitedHealthcare - This screen is intended only as general information. It presents only a brief overview of some of the standard benefits of the product(s) shown. Optional benefits may be available for additional premium.
- UnitedHealthcare - Before you apply, please use the link(s) provided to download and review the product information for a more complete explanation of benefits, exclusions (including any that may apply to preexisting conditions), limitations, terms under which the product(s) may not be renewed or benefits may be reduced, and any state variations applicable to any of these items.
- UnitedHealthcare - You must meet our eligibility requirements in order to become insured, which may include medical underwriting. There is no coverage until we inform you in writing that your application has been processed and approved.
- UnitedHealthcare - To be considered for reimbursement, expenses must qualify as "covered expenses" under the policy, and are also subject to all other policy provisions, such as reasonable and customary or eligible expense limits, or whether or not they were medically necessary.
- UnitedHealthcare - Estimated Premium shown is based on the information you provided, and is subject to change based on the product(s) you select, optional benefits you select (if any), and other factors. We shall exclusively determine the premium actually required, and the effective date of any coverage issued.
- UnitedHealthcare - These plans pay non-network provider benefits based on the network negotiated rate. Non-network dentists can bill a patient for any remaining amount up to the billed charge.