Ameritas offers various Dental PPO (Preferred Provider Organization) plans that provide flexibility and cost-saving options for dental care. Understanding the specifics of the maximums and deductibles in these plans is crucial for managing your dental expenses effectively. Here’s a detailed overview:
Annual Maximum
The annual maximum is the total amount Ameritas will pay for your dental care in a plan year. Once this limit is reached, you are responsible for 100% of any additional dental costs for the remainder of the year. The annual maximum varies depending on the plan you choose. Common ranges for Ameritas PPO plans are:
- Low Coverage Plans: $1,000 to $1,500 per year
- Mid Coverage Plans: $1,500 to $2,000 per year
- High Coverage Plans: $2,000 to $3,000 per year
Deductible
The deductible is the amount you must pay out-of-pocket before your Ameritas PPO dental plan starts covering costs. There are two primary types of deductibles:
- Individual Deductible: The amount an individual must pay before benefits begin. This can range from $25 to $100 per year, depending on your plan.
- Family Deductible: The collective amount a family must pay before benefits start. This is usually higher than the individual deductible and can range from $50 to $300 per year.
Key Features of Ameritas PPO Dental Plans
- In-Network vs. Out-of-Network: Ameritas PPO plans allow you to see any dentist, but you save money by visiting dentists within the Ameritas network. In-network dentists have agreed to reduced rates, which means lower out-of-pocket costs for you.
- Coverage Levels:
- Preventive Services: Typically covered at 100% without a deductible. This includes routine exams, cleanings, and X-rays.
- Basic Services: Generally covered at 70-80% after the deductible is met. This includes fillings, simple extractions, and some types of root canals.
- Major Services: Often covered at 50% after the deductible. This includes crowns, bridges, dentures, and complex oral surgeries.
- Orthodontic Coverage: Some Ameritas PPO plans include orthodontic coverage, usually with a separate lifetime maximum and a specific deductible. This benefit is often for children, though some plans offer adult orthodontic coverage.
- Preventive Incentive: Some plans do not count preventive care towards your annual maximum, encouraging regular check-ups and cleanings without affecting your coverage for other dental services.
- Rollover Options: Certain plans allow unused portions of your annual maximum to roll over to the next year, providing more flexibility in managing dental expenses.
Tips for Managing Your Plan
- Regular Check-ups: Utilize preventive services covered at 100% to catch issues early and avoid higher costs later.
- Track Your Spending: Be aware of your annual maximum and monitor your spending to avoid unexpected out-of-pocket expenses.
- Use In-Network Dentists: To save money, always try to visit dentists within the Ameritas network.
- Review Your Plan Details: Understand your specific plan, including covered services and limits, to make the most of your benefits.
- Plan for Major Services: If you anticipate needing major dental work, plan accordingly to manage costs and stay within your maximum.
Still confused? Don’t worry!
At Sunnyvale Dental Care we are committed to making the process of receiving care and maximizing your dental benefits as painless as possible! We are an Ameritas PPO dental preferred provider.
By understanding the annual maximum and deductible of your Ameritas PPO dental plan, you can better manage your dental health and expenses throughout the year. Regular dental visits and strategic use of your benefits can help maintain your oral health while staying within your budget.