Advantages of Dental Choice Plus

Dental Choice Benefits

Reimbursement
Method In/Out

Standard Pays**
Yr.1/Yr.2/Yr.3+

Enhanced Pays**
Yr.1/Yr.2/Yr.3+

Diagnostic & Preventative   No Wait 100% / 100% / 100% 100% / 100% / 100%
Basic (Fillings & Simple Extraction) Basic 6 mo 50% / 65% / 80% 50% / 65% / 80%
Endodontic Major 12 Months* 0%* / 25% / 50% 0%* / 25% / 50%
Periodontics Major 12 Months* 0%* / 25% / 50% 0%* / 25% / 50%
Oral Surgery Major 12 Months* 0%* / 25% / 50% 0%* / 25% / 50%
Restorations Major 12 Months* 0%* / 25% / 50% 0%* / 25% / 50%
Orthodontics Major 12 Months* 0%* / 25% / 50% 0%* / 25% / 50%
Prosthodontics Major 12 Months* 0%* / 25% / 50% 0%* / 25% / 50%
Co-Pay (Per Person, Per Visit)
No more than 3 per person per calendar year
$25 Thru age 64
$40 age 65 and over
$25 Thru age 64
$40 age 65 and over
Insurance Calendar Year Maximum per person per calendar year $1,500 $2,000
Orthodontic and Prosthodontics Lifetime Maximum ($1,000 Lifetime Max, Limited to $350 per Calendar Yr. per each benefit listed) $1,000 $1,000
Routine oral exams are limited to 1 per 6 months, bitewing X-rays limited to 1 per calendar year, full mouth X-rays (Panoramic Film or full Series) must be no less than 36 months apart, fluoride for dependent children under 19 is limited to 1 per calendar year and periodontal maintenance procedure are to be no less than 6 months apart. Please refer to your policy for other benefit limitations.

*Insured pays only the discounted pre-negotiated network provider rate.
**Annual coinsurance amounts are based on policy years.

 
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Dental Choice Description   Claim Form
 
Hearing care

Hearing Care

Amplifon logo
  • Save 40% on diagnostic services, including hearing exams, at over 3,800 provider locations nationwide.
  • Hearing aid low price guarantee: If you should find the same product at a lower price, bring us the local quote and we'll not only match it, we'll beat it by 5%!
  • 2 years of free batteries (80 cells per hearing aid, per year)

HRPO

Vision care

Vision Care

EyeMed logo
  • Members save 20% to 40% off the retail price of eyewear with the EyeMed Vision Care Access Plan D discount program through the Access network. Members are eligible for discounts on exams, eyeglasses and contact lenses from more than 90,000 providers nationwide including independent optometrists, ophthalmologists, opticians and leading optical retailers such as LensCrafters®, Sears Optical®, Target Optical®, JCPenney® Optical and most Pearle Vision® locations.

EYEM

LASIK vision correction

LASIK vision correction

National Lasik Network Logo

Receive significant savings when you choose any of the 600+ locations nationwide.*

  • Members receive exclusive discounts through LasikPlus.
  • All other in-network providers extend discounts of 15% off standard prices or 5% off promotional prices.
Special Member Prices**
Traditional LASIK - bladeless
Free enhancements for 1 year
$695* per eye
Traditional LASIK - bladeless
Free enhancements for life
$1,395 per eye
Custom LASIK - bladeless
Free enhancements for life
$1,895 per eye
*Nearsightedness better than -2, with astigmatism better than -1 and other restrictions may apply.

*Product not available in MT

**Special member prices only available through LasikPlus

LCA - 08/08/17


Your plan premium and benefits are based on your area of residency. Your premium and benefits may change if you move to a different area. This plan will terminate and no benefits will be payable if you are no longer a permanent resident of the United States or no longer reside in a state where the form is approved.

© Administered by Careington International Corporation | 7400 Gaylord Parkway, Frisco, TX 75034

*Vision, LASIK and Hearing products and services are not insurance.

Disclosure:
THIS PLAN IS NOT INSURANCE and is not intended to replace health insurance.
This plan does not meet the minimum creditable coverage requirements under M.G.L. c. 111M and 956 CMR 5.00. This plan is not a Qualified Health Plan under the Affordable Care Act. The range of discounts will vary depending on the type of provider and service. The plan does not pay providers directly. Plan members must pay for all services but will receive a discount from participating providers. The list of participating providers is on this website. A written list of participating providers is available upon request. Discount Plan Organization and administrator: Careington International Corporation, 7400 Gaylord Parkway, Frisco, TX 75034; phone 800-441-0380.

This plan is not available in Vermont.