72 lines
4.5 KiB
Text
72 lines
4.5 KiB
Text
PLAN: Equitable Dental Plan
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UID: Equitable Dental Plan
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Category: Dental
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Type: None
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Marketing Name: Equitable Dental
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Average Price: $65.64
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Short Description: A flexible PPO dental plan with coverage for preventive, basic, and major services, plus child orthodontia in higher tiers. Choose any dentist, with the best savings in-network.
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Long Description: The Equitable Dental PPO Plan offers comprehensive dental coverage with access to both in-network and out-of-network providers. Preventive care is covered at 100% across all tiers, while basic and major services are covered at varying coinsurance levels depending on the plan tier (Low, Mid, or High). Annual benefit maximums range from $1,000 to $3,000, and child orthodontia is included in the Mid and High plans. In-network providers offer significant savings through discounted contracted rates, giving members flexibility and value.
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PRICING:
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Coverage 4: $103.18
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Coverage 3: $75.62
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Coverage 2: $55.68
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Coverage 1: $28.11
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DETAILS:
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COVERAGE:
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Coinsurance - In Network: 100% – Preventive care (like cleanings, exams, and X-rays).80% – Basic care (like fillings and simple extractions).50% – Major care (like crowns, dentures, and root canals).
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Coinsurance - Out of Network: 100% – Preventive care (like cleanings, exams, and X-rays).80% – Basic care (like fillings and simple extractions).50% – Major care (like crowns, dentures, and root canals).
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Missing Tooth Clause - In Network: Pre-existing missing teeth not covered
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Missing Tooth Clause - Out ofNetwork: Pre-existing missing teeth not covered
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Annual Individual Maxium Benefit - In Network: 1000
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Annual Individual Maxium Benefit - Out of Network: 1000
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Annual Individual / Family Deductible - In Network: $50 deductible per person For a family, you only have to pay it for 3 people max (so $150 total), even if more are covered and preventive services are free.
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Annual Individual / Family Deductible - Out of Network: $50 deductible per person For a family, you only have to pay it for 3 people max (so $150 total), even if more are covered and preventive services are free.
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Reimbursement (how much the insurance company pays thef or care) - In Network: Agreed Rate
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Reimbursement (how much the insurance company pays thef or care) - Out of Network: Fixed Coverage Amount
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Alternative Benefit (If two treatments would fix the problem, the plan pays for the less expensive one) - In Network: Included
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Alternative Benefit (If two treatments would fix the problem, the plan pays for the less expensive one) - Out of Network: Included
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BASICSERVICES:
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Simple Extractions - In Network: 80%
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Simple Extractions - Out of Network: 80%
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Periodontal Maintenance - In Network: 80%
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Periodontal Maintenance - Out of Network: 80%
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Emergency Palliative Treatment - In Network: 80%
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Complete Series/ Panoramic X-Rays - In Network: 80%
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Emergency Palliative Treatment - Out of Network: 80%
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Complete Series/ Panoramic X-Rays - Out of Network: 80%
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Basic Restorative Services (amalgam, composite resin, acrylic, synthetic or plastic fillings) - In Network: 80%
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Basic Restorative Services (amalgam, composite resin, acrylic, synthetic or plastic fillings) - Out of Network: 80%
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MAJORSERVICES:
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Bridges - In Network: 50%
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Bridges - Out of Network: 50%
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Oral Surgery - In Network: 50%
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Bitewing X-Rays - In Network: 50%
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Oral Surgery - Out of Network: 50%
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Bitewing X-Rays - Out of Network: 50%
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Periodontal Surgery - In Network: 50%
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Inlays/Onlays/Crowns - In Network: 50%
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Surgical Endodontics - In Network: 50%
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Periodontal Surgery - Out of Network: 50%
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Inlays/Onlays/Crowns - Out of Network: 50%
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Non-Surgical Endodontics - In Network: 50%
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Non-Surgical Periodontal - In Network: 50%
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Surgical Endodontics - Out of Network: 50%
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Non-Surgical Endodontics - Out of Network: 50%
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Non-Surgical Periodontal - Out of Network: 50%
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Surgical Extractions and Removal of Impacted Teeth - In Network: 80%
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Surgical Extractions and Removal of Impacted Teeth - Out of Network: 50%
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Dentures – complete, partial, overdenture (upper and lower) - In Network: 50%
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Dentures – complete, partial, overdenture (upper and lower) - Out of Network: 50%
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PREVENTIVESERVICES:
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Periodic Oral Evaluation - In Network: 100%
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Periodic Oral Evaluation - Out of Network: 100%
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Comprehensive Oral Evaluation - In Network: 100%
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Comprehensive Oral Evaluation - Out of Network: 100%
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Limited Oral Evaluation (problem focused) - In Network: 100%
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Limited Oral Evaluation (problem focused) - Out of Network: 100%
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