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Our second installment of Know Your Coverage takes a quick look at dental benefits terms anyone can benefit from understanding. We cover some of the most important aspects of your coverage such as plan maximums, network coverage, preventive care and more. Read Know Your Coverage Part 1 here.
1. Annual maximum: The maximum amount your plan will pay for dental procedures during an annual period. Once you reach the maximum, you’ll be solely responsible for additional dental fees.1 TruAssure’s Choice and Choice Plus plans offer flexibility and allow you to choose your annual maximum.
2. Basic services: Services needed to treat common dental conditions such as fillings and extractions. The cost for these services varies depending on your plan.2
3. In-network: Visiting an in-network dentist is one of the primary ways to save when it comes to dental care. In-network dentists have been certified by your benefits carrier and have agreed to reduced fees that save patients 20 to 40 percent on average.3
4. Lifetime maximum: The total dollar amount a dental benefits plan will cover over the course of a lifetime. Depending on the plan, this may apply to some or all dental services.
5. Major annual maximum: The highest dollar amount a plan covers each year for procedures classified as “major services,”4 which is defined next.
6. Major services: A classification describing complex or more costly treatments such as dentures, crowns and bridges.5
7. Orthodontic coverage: Dental benefits that apply to orthodontic services like braces or retainers. Though most plans often don’t cover orthodontia for children and adults, TruAssure offers plans that provide orthodontic coverage.6
8. Orthodontic maximum: The highest dollar amount a carrier will contribute towards fees for orthodontic services over the course of a lifetime.7
9. Out-of-network: A dentist who doesn’t participate in your plan’s network. Visits to out-of-network dentists might not be covered by your plan, and these dentists may charge you higher rates than in-network dentists because they haven’t agreed to set fee limits.
10. Preventive services: Dental procedures like regular checkups and cleanings that help prevent more serious oral health issues like cavities and gum disease.
Need a dentist near home, work or your kids' school? With one of the largest networks in the country, we make it easy to find a dentist who fits your location and your schedule.
* All TruAssure dental plans, other than Basic and Preferred dental plans, are offered in association with the DenteMax Plus dental network arrangement, which includes participating dentists from the DenteMax, United Concordia and Connection dental networks. TruAssure Basic and Preferred dental plans for both group and individual members are offered in association with the DenteMax dental network.
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