- Keep your dentist or choose an In-Network dentist and save
- Over 400,000 providers to choose from, whether home or away
- No waiting period on covered services – get access right away
- Covers exams, cleanings, fillings, crowns, and more
- High annual maximum
that can increase after one year
Member
$29.89/month
$52.71/month
Member +1
$61.48/month
$105.42/month
Member +Family
$79.86/month
$146.70/month
Deductible
$75.00 per year/person
$75.00
per year/person
(waived for Preventative services)
In Network
$1,000.00 per year/person
$1,500.00 per year/person
Out of Network
$1,000.00 per year/person
$1,500.00 per year/person
Annual Benefit Threshold
$500.00
$750.00
Annual Maximum Benefit
$1,000.00
$1,500.00
Dental Rewards Carry Over
$250.00
$250.00
Year 2 Maximum Benefit
$1,250.00
$1,750.00
Total Maximum Benefit
$2,000.00
$2,500.00
Preventative
X-Rays
M.C.E. $40 (bitewing 4 image)
M.C.E. $73 (panoramic)
Covers 80% (all types)
Routine Cleanings
M.C.E. $60
Covers 100%
Routine Oral Exams
M.C.E. $28
Covers 100%
Basic
Extractions
M.C.E. $77 (simple)
Covers 80%
Fillings
M.C.E. $87 (2 surface amalgam)
M.C.E. $116 (2 surface resin)
Covers 80%
Periodontics
M.C.E. $350 (osseous surgery)
Covers 50%
Root Canal
M.C.E. $501 (premolar tooth)
Covers 50% (all types)
Crown Repair
Not Covered
Covers 80%
Denture Repair
Not Covered
Covers 80%
General Anesthesia
Not Covered
Covers 80%
X-Rays
M.C.E. $40 (bitewing 4 image)
M.C.E. $73 (panoramic)
Covers 80% (all types)
Major
Crown
M.C.E. $392 (full cast noble metal)
Covers 50% (all types)
Dentures
M.C.E. $483 (maxillary)
Covers 50% (all types)
Onlay (2 surface, metallic)
M.C.E. $388
Not Covered
Root Canal
M.C.E. $501 (premolar tooth)
Covers 50% (all types)
Periodontics
M.C.E. $350 (osseous surgery)
Covers 50%
Use your current dentist OR Save 25-50% with a dentist in our network.
Find a dentist
(note: Enter zip, select city & state, and Classic PPO network.)
Details may vary based on start date. Please note it may take 10-15 days to process your enrollment. You will receive a ‘welcome to the program’ letter which will include your group number and carrier details. Please consult your policy as the final ultimate source of covered services and program details.
Rates valid from 1 February, 2023 to 31 January, 2025.
{
"services": {
"X-Rays": {
"Gold": "M.C.E. $40 (bitewing 4 image)<\/span>
M.C.E. $73 (panoramic)<\/span>",
"Platinum": "Covers 80% (all types)<\/span>"
},
"Routine Cleanings": {
"Gold": "M.C.E. $60",
"Platinum": "Covers 100%"
},
"Routine Oral Exams": {
"Gold": "M.C.E. $28",
"Platinum": "Covers 100%"
},
"Extractions": {
"Gold": "M.C.E. $77 (simple)<\/span>",
"Platinum": "Covers 80%"
},
"Fillings": {
"Gold": "M.C.E. $87 (2 surface amalgam)<\/span>
M.C.E. $116 (2 surface resin)<\/span>",
"Platinum": "Covers 80%"
},
"Periodontics": {
"Gold": "M.C.E. $350 (osseous surgery)<\/span>",
"Platinum": "Covers 50%"
},
"Root Canal": {
"Gold": "M.C.E. $501 (premolar tooth)<\/span>",
"Platinum": "Covers 50% (all types)<\/span>"
},
"Crown Repair": {
"Platinum": "Covers 80%"
},
"Denture Repair": {
"Platinum": "Covers 80%"
},
"General Anesthesia": {
"Platinum": "Covers 80%"
},
"Crown": {
"Gold": "M.C.E. $392 (full cast noble metal)<\/span>",
"Platinum": "Covers 50% (all types)<\/span>"
},
"Dentures": {
"Gold": "M.C.E. $483 (maxillary)<\/span>",
"Platinum": "Covers 50% (all types)<\/span>"
},
"Onlay (2 surface, metallic)": {
"Gold": "M.C.E. $388"
}
},
"plans": {
"Gold": {
"inEffect": "2023-02-01T00:00:00",
"marketingInEffect": "2022-12-15T00:00:00",
"outOfEffect": "2025-01-31T00:00:00",
"marketingOutOfEffect": "2024-12-15T00:00:00",
"policyNumber": "350960",
"cleaningsPerPeriod": 2,
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"orthoEliminationPeriod": 12,
"examFrequency": 2,
"examPeriod": "Benefit Period",
"orthoCoverageDescription": "Dependents Only",
"orthoLifetimeMax": 0,
"orthoCoInsurance": 0,
"annualPlanMax": 1000,
"outOfNetAnnualPlanMax": 1000,
"rewardsThreshold": 500,
"rewardsAnnualRollover": 250,
"ppobonus": 0,
"rewardsMaxRollover": 1000,
"waitingPeriod": null,
"notes": null,
"deductible": 75,
"familyDeductibleMax": 0,
"dentalRewards": true,
"planLevel": "Gold",
"dentalNetworkDescription": "Non-PPO \/ Out-Of-Network Benefits",
"frequencyType": "Annual",
"carrier": {
"fullName": "Ameritas Life Insurance Corp",
"shortName": "Ameritas",
"logo": "\/img\/ameritas.png",
"creativeApproval": "2020-03-11T19:51:51.743",
"legalName": "Ameritas Life Insurance Corp (Ameritas Life)",
"website": "https:\/\/dentalnetwork.ameritas.com\/",
"phone": "1-877-983-3582",
"instructions": "Enter zip, select city & state, and Classic PPO network."
},
"dentalPlanCoverage": [
{
"rate": 29.89,
"coverage": "Member"
},
{
"rate": 61.48,
"coverage": "Member +1"
},
{
"rate": 79.86,
"coverage": "Member +Family"
}
],
"dentalPlanType": [
{
"dentalType": null,
"inNetworkPercent": 0,
"outOfNetworkPercent": 0,
"deductibleWaived": false,
"dentalPlanTypeIncentive": [],
"dentalPlanTypeProcedure": [
{
"frequency": 0,
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"frequencyType": null,
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},
{
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"frequencyType": null,
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},
{
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"frequencyType": null,
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},
{
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]
},
{
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"dentalPlanTypeIncentive": [],
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{
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"frequencyType": null,
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},
{
"frequency": 0,
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"frequencyType": null,
"name": "Fillings (2 surface amalgam)"
},
{
"frequency": 0,
"mceamount": 116,
"frequencyType": null,
"name": "Fillings (2 surface resin)"
},
{
"frequency": 0,
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"frequencyType": null,
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},
{
"frequency": 0,
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"frequencyType": null,
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}
]
},
{
"dentalType": null,
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"dentalPlanTypeIncentive": [],
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{
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"frequencyType": null,
"name": "Crown (full cast noble metal)"
},
{
"frequency": 0,
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"frequencyType": null,
"name": "Denture (maxillary)"
},
{
"frequency": 0,
"mceamount": 388,
"frequencyType": null,
"name": "Onlay (2 surface, metallic)"
}
]
}
],
"inEffectDate": "2023-02-01",
"inEffectTimestamp": 1675209600,
"outOfEffectDate": "2025-01-31",
"outOfEffectTimestamp": 1738281600,
"marketingInEffectDate": "2022-12-15",
"marketingInEffectTimestamp": 1671062400,
"inEffectDateCalc": "2022-12-15",
"marketingOutOfEffectDate": "2024-12-15",
"marketingOutOfEffectTimestamp": 1734220800,
"startTimestamp": 1704067200,
"isInEffect": true,
"marketingIsInEffect": true,
"planLevelText": "Essential Coverage",
"frequencyText": "per year & per person",
"frequencyTextAlt": "per year\/person",
"planCoverage": [
{
"rate": 29.89,
"coverage": "Member"
},
{
"rate": 61.48,
"coverage": "Member +1"
},
{
"rate": 79.86,
"coverage": "Member +Family"
}
],
"planType": "dental",
"types": [
{
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"inNetworkPercent": 0,
"outOfNetworkPercent": 0,
"deductibleWaived": false,
"dentalPlanTypeIncentive": [],
"dentalPlanTypeProcedure": [
{
"frequency": 0,
"mceamount": 40,
"frequencyType": null,
"name": "Bitewing X-rays (4 image)"
},
{
"frequency": 0,
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"frequencyType": null,
"name": "Panoramic X-Rays"
},
{
"frequency": 0,
"mceamount": 60,
"frequencyType": null,
"name": "Routine Cleanings"
},
{
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"frequencyType": null,
"name": "Routine Oral Exams"
}
],
"covers": "Covers 0%"
},
{
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"outOfNetworkPercent": 0,
"deductibleWaived": false,
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"frequencyType": null,
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},
{
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{
"frequency": 0,
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"frequencyType": null,
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},
{
"frequency": 0,
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"frequencyType": null,
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{
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}
],
"covers": "Covers 0%"
},
{
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{
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{
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}
],
"covers": "Covers 0%"
}
],
"waived": [],
"waivedLabeled": false
},
"Platinum": {
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"marketingInEffect": "2022-12-15T00:00:00",
"outOfEffect": "2025-01-31T00:00:00",
"marketingOutOfEffect": "2024-12-15T00:00:00",
"policyNumber": "350960",
"cleaningsPerPeriod": 2,
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"orthoEliminationPeriod": 0,
"examFrequency": 2,
"examPeriod": "Benefit Period",
"orthoCoverageDescription": "None",
"orthoLifetimeMax": 0,
"orthoCoInsurance": 0,
"annualPlanMax": 1500,
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"rewardsThreshold": 750,
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"ppobonus": 150,
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"notes": null,
"deductible": 75,
"familyDeductibleMax": 225,
"dentalRewards": true,
"planLevel": "Platinum",
"dentalNetworkDescription": "Non-PPO \/ Out-Of-Network Benefits",
"frequencyType": "Annual",
"carrier": {
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"shortName": "Ameritas",
"logo": "\/img\/ameritas.png",
"creativeApproval": "2020-03-11T19:51:51.743",
"legalName": "Ameritas Life Insurance Corp (Ameritas Life)",
"website": "https:\/\/dentalnetwork.ameritas.com\/",
"phone": "1-877-983-3582",
"instructions": "Enter zip, select city & state, and Classic PPO network."
},
"dentalPlanCoverage": [
{
"rate": 52.71,
"coverage": "Member"
},
{
"rate": 105.42,
"coverage": "Member +1"
},
{
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}
],
"dentalPlanType": [
{
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{
"frequency": 2,
"mceamount": 0,
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{
"frequency": 2,
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"frequencyType": "Plan Period",
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]
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{
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{
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"mceamount": 0,
"frequencyType": null,
"name": "Crown Repair"
},
{
"frequency": 0,
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"name": "Denture Repair"
},
{
"frequency": 0,
"mceamount": 0,
"frequencyType": null,
"name": "Fillings"
},
{
"frequency": 0,
"mceamount": 0,
"frequencyType": null,
"name": "General Anesthesia"
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{
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"mceamount": 0,
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"name": "X-rays"
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{
"frequency": 0,
"mceamount": 0,
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"name": "Extractions"
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]
},
{
"dentalType": null,
"inNetworkPercent": 0.5,
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"dentalPlanTypeIncentive": [],
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"name": "Crowns"
},
{
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"mceamount": 0,
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"name": "Dentures"
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{
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{
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"frequencyType": null,
"name": "Periodontics (gum disease)"
}
]
}
],
"inEffectDate": "2023-02-01",
"inEffectTimestamp": 1675209600,
"outOfEffectDate": "2025-01-31",
"outOfEffectTimestamp": 1738281600,
"marketingInEffectDate": "2022-12-15",
"marketingInEffectTimestamp": 1671062400,
"inEffectDateCalc": "2022-12-15",
"marketingOutOfEffectDate": "2024-12-15",
"marketingOutOfEffectTimestamp": 1734220800,
"startTimestamp": 1704067200,
"isInEffect": true,
"marketingIsInEffect": true,
"planLevelText": "Most Comprehensive",
"frequencyText": "per year & per person",
"frequencyTextAlt": "per year\/person",
"planCoverage": [
{
"rate": 52.71,
"coverage": "Member"
},
{
"rate": 105.42,
"coverage": "Member +1"
},
{
"rate": 146.7,
"coverage": "Member +Family"
}
],
"planType": "dental",
"types": [
{
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"inNetworkPercent": 1,
"outOfNetworkPercent": 1,
"deductibleWaived": true,
"dentalPlanTypeIncentive": [],
"dentalPlanTypeProcedure": [
{
"frequency": 2,
"mceamount": 0,
"frequencyType": "Plan Period",
"name": "Routine Cleanings"
},
{
"frequency": 2,
"mceamount": 0,
"frequencyType": "Plan Period",
"name": "Routine Oral Exams"
}
],
"covers": "Covers 100%"
},
{
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"dentalPlanTypeIncentive": [],
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{
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"name": "Crown Repair"
},
{
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"frequencyType": null,
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},
{
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"frequencyType": null,
"name": "Fillings"
},
{
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},
{
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},
{
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"mceamount": 0,
"frequencyType": null,
"name": "Extractions"
}
],
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},
{
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{
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"frequencyType": null,
"name": "Crowns"
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},
{
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"frequencyType": null,
"name": "Endodontics (root canals)"
},
{
"frequency": 0,
"mceamount": 0,
"frequencyType": null,
"name": "Periodontics (gum disease)"
}
],
"covers": "Covers 50%"
}
],
"waived": [
1
],
"waivedLabeled": [
"Preventative"
]
}
},
"procedures": {
"X-Rays": {
"bitewing 4 image)": 1,
"panoramic)": 1,
"all types)": 1
},
"Routine Cleanings": {
"": 1
},
"Routine Oral Exams": {
"": 1
},
"Extractions": {
"simple)": 1,
"": 1
},
"Fillings": {
"2 surface amalgam)": 1,
"2 surface resin)": 1,
"": 1
},
"Periodontics": {
"osseous surgery)": 1,
"": 1
},
"Root Canal": {
"premolar tooth)": 1,
"all types)": 1
},
"Crown": {
"full cast noble metal)": 1,
"all types)": 1
},
"Dentures": {
"maxillary)": 1,
"all types)": 1
},
"Onlay": {
"2 surface, metallic)": 1
},
"Crown Repair": {
"": 1
},
"Denture Repair": {
"": 1
},
"General Anesthesia": {
"": 1
}
},
"coverage": {
"Member": {
"Gold": 29.89,
"Platinum": 52.71
},
"Member +Associate": [],
"Member +Spouse": [],
"Member +1": {
"Gold": 61.48,
"Platinum": 105.42
},
"Member +Family": {
"Gold": 79.86,
"Platinum": 146.7
},
"Member +Children": []
},
"annualPlanMax": {
"Gold": 1000,
"Platinum": 1500
},
"outOfNetAnnualPlanMax": {
"Gold": 1000,
"Platinum": 1500
},
"rewardsThreshold": {
"Gold": 500,
"Platinum": 750
},
"rewardsAnnualRollover": {
"Gold": 250,
"Platinum": 250
},
"rewardsMaxRollover": {
"Gold": 1000,
"Platinum": 1000
},
"type_1": {
"inNetworkPercent": {
"Gold": 0,
"Platinum": 1
},
"outOfNetworkPercent": {
"Gold": 0,
"Platinum": 1
},
"deductibleWaived": {
"Gold": false,
"Platinum": true
},
"services": {
"X-Rays": {
"Gold": 1
},
"Routine Cleanings": {
"Gold": 1,
"Platinum": 1
},
"Routine Oral Exams": {
"Gold": 1,
"Platinum": 1
}
}
},
"type_2": {
"inNetworkPercent": {
"Gold": 0,
"Platinum": 0.8
},
"outOfNetworkPercent": {
"Gold": 0,
"Platinum": 0.8
},
"deductibleWaived": {
"Gold": false,
"Platinum": false
},
"services": {
"Extractions": {
"Gold": 1,
"Platinum": 1
},
"Fillings": {
"Gold": 1,
"Platinum": 1
},
"Periodontics": {
"Gold": 1
},
"Root Canal": {
"Gold": 1
},
"Crown Repair": {
"Platinum": 1
},
"Denture Repair": {
"Platinum": 1
},
"General Anesthesia": {
"Platinum": 1
},
"X-Rays": {
"Platinum": 1
}
}
},
"type_3": {
"inNetworkPercent": {
"Gold": 0,
"Platinum": 0.5
},
"outOfNetworkPercent": {
"Gold": 0,
"Platinum": 0.5
},
"deductibleWaived": {
"Gold": false,
"Platinum": false
},
"services": {
"Crown": {
"Gold": 1,
"Platinum": 1
},
"Dentures": {
"Gold": 1,
"Platinum": 1
},
"Onlay (2 surface, metallic)": {
"Gold": 1
},
"Root Canal": {
"Platinum": 1
},
"Periodontics": {
"Platinum": 1
}
}
}
};