|
INDIVIDUAL - FAMILY |
||
 |
||
|
InsuranceCompany.com is a specialist in discount dental care,
dental plans, vision and prescription coverage programs. We
have
been in business since 1983 and
offer several national dental, vision and
prescription
programs depending upon the
state you live in...
Monthly premiums are $9.95 for an individual and $15 for the family plan. A family membership covers all residents in the household, including children, parents, relatives, significant others, and all permanent residents of the household. This dental package (plan 505) includes dental, vision and prescription (Rx) coverage. The plan offers a choice of more than 18,000 dental providers nationwide - all carefully credentialed to offer the kind of care we demand and our patients expect. Our dentists must meet the Plan's standard of quality and service. All have agreed to provide dental care at the low co-payments available only to members. Order on-line today... Start saving up to 20-70% or more on dental charges including restorative, cosmetic work (fillings, crowns, implants, braces, etc.) and preventative work (teeth cleaning, x-rays, etc.) General dentistry and all specialties where available are covered. There is no maximum benefit, no deductibles, no claim forms to fill out and you can go to the dentist as many times as you need too...
There is no waiting period for your dental coverage to begin, pre-existing dental conditions are covered and best of all, the dental plan coverage starts the next business day, so you can see the plan dentist immediately. However, there is no coverage for any "dental work in progress" before entering the plan related to orthodontics.
|
||
Next Day Coverage ! Order Today...
|
ADA |
SCHEDULE
OF BENEFITS CAREington Preferred Dental Plan 505 |
With This Plan You Pay the Dentist |
Without This Plan You Would Pay The State Average |
|
 Pay By Credit Card |
Pay By Check |
|||
| 0120 |  PERIODIC
ORAL EVALUATION |
$16 | $35.00 | |
| 0140 | LIMITED ORAL EVALUATION--PROBLEM FOCUS | $20 | $49.00 | |
| 0150 | COMPREHENSIVE ORAL EVALUATION | $20 | $59.00 | |
| 0210 | X-RAYS--INTRAORAL--COMPLETE SERIES (INC. BITEWINGS) | $48 | $90.00 | |
| 0220 | X-RAYS--INTRAORAL--PERIAPICAL--1ST FILM | $11 | $19.00 | |
| 0230 | X-RAYS--INTRAORAL PERIAPICAL--EACH ADDITIONAL FILM | $5 | $16.00 | |
| 0270 | BITEWING X-RAY--SINGLE FILM | $12 | $19.00 | |
| 0272 | BITEWINGS--TWO FILMS | $15 | $30.00 | |
| 0274 | BITEWINGS--FOUR FILMS | $24 | $44.00 | |
| 0330 | PANORAMIC FILM | $48 | $79.00 | |
| 1110 | PROPHY-ADULT CLEANING | $36 | $65.00 | |
| 1120 | PROPHY-CHILD CLEANING | $29 | $45.00 | |
| 1201 | TOPICAL APPLICATION OF FLUORIDE (INCLUDING PROPHY)-CHILD | $40 | $67.00 | |
| 1351 | SEALANT-PER TOOTH | $23 | $37.00 | |
| 1510 | SPACE MAINTAINER-FIXED-UNILATERAL | $105 | $240.00 | |
| 1515 | SPACE MAINTAINER-FIXED-BILATERAL |
$154 | $330.00 | |
| 1520 | SPACE MAINTAINER-REMOVEABLE-UNILATERAL | $137 | $292.00 | |
| 1525 | SPACE MAINTAINER-REMOVEABLE-BILATERAL | $174 | $367.00 | |
| 2110 | AMALGAM-ONE SURFACE PRIMARY | $41 | $73.00 | |
| 2120 | AMALGAM-TWO SURFACE PRIMARY | $55 | $92.00 | |
| 2130 | AMALGAM-THREE SURFACE PRIMARY | $66 | $110.00 | |
| 2131 | AMALGAM-FOUR OR MORE-PRIMARY | $77 | $133.00 | |
| 2140 | AMALGAM-ONE SURFACE PERMANENT | $48 | $83.00 | |
| 2150 | AMALGAM-TWO SURFACE PERMANENT | $61 | $110.00 | |
| 2160 | AMALGAM-THREE SURFACE PERMANENT | $72 | $131.00 | |
| 2161 | AMALGAM-FOUR OR MORE PERMANENT | $89 | $160.00 | |
| 2330 | RESIN-ONE SURFACE ANTERIOR | $61 | $100.00 | |
| 2331 | RESIN-TWO SURFACE ANTERIOR | $74 | $130.00 | |
| 2332 | RESIN-THREE SURFACE ANTERIOR | $93 | $162.00 | |
| 2335 | RESIN-FOUR OR MORE SURFACES | $117 | $201.00 | |
| 2385 | RESIN-ONE SURF-POSTERIOR-PERMANENT | $81 | $112.00 | |
| 2386 | RESIN-TWO SURF-POSTERIOR-PERMANENT | $115 | $155.00 | |
| 2387 | RESIN-THREE OR MORE-POSTERIOR PERMANENT | $153 | $196.00 | |
| 2750 | CROWN-PORCELAIN FUSED HIGH NOBLE METAL | $550 | $780.00 | |
| 2751 | CROWN-PORCELAIN FUSED TO PREDOMINANTLY BASE METAL | $496 | $706.00 | |
| 2752 | CROWN-PORCELAIN FUSED TO NOBLE METAL |
$525 | $727.00 | |
| 2790 | CROWN-FULL CAST HIGH NOBLE METAL | $530 | $761.00 | |
| 2791 | CROWN-FULL CAST-PREDOMINANTLY BASE METAL | $505 | $692.00 | |
| 2930 | PREFAB STAINLESS STEEL CROWN- PRIMARY | $113 | $192.00 | |
| 2931 | PREFAB STAINLESS STEEL CROWN- PERMANENT | $129 | $228.00 | |
| 2950 | CORE BUILDUP-INCLUDING ANY PINS | $113 | $190.00 | |
| 2951 | PIN RETENTION/TOOTH IN ADDITION TO RESTORATION | $26 | $49.00 | |
| 2952 | CAST POST AND CORE IN ADDITION TO CROWN | $177 | $302.00 | |
| 2954 | PREFAB POST AND CORE IN ADDITION TO CROWN | $138 | $243.00 | |
| 3110 | PULP CAP DIRECT (EXCL FNL REST) | $25 | $56.00 | |
| 3120 | PULP CAP INDIRECT (EXCL FNL REST) | $25 | $60.00 | |
| 3220 | THERAPEUTIC PULPOTOMY (EXCL FNL REST) | $61 | $135.00 | |
| 3310 | ROOT CANAL--ANTERIOR (EXCL FNL REST) | $330 | $471.00 | |
| 3320 | ROOT CANAL--BICUSPID (EXCL FNL REST) | $391 | $565.00 | |
| 3330 | ROOT CANAL--MOLAR (EXCL FNL REST) | $491 | $689.00 | |
| 4210 | GINGIVECTOMY OR GINGIVOPLASTY/QUAD | $330 | $450.00 | |
| 4341 | PERIO SCALING AND ROOT PLANING/QUAD | $110 | $175.00 | |
| 4910 | PERIO MAINTENANCE | $70 | $95.00 | |
| 5110 | COMPLETE DENTURE-MAXILLARY | $715 | $1,100.00 | |
| 5120 | COMPLETE
DENTURE-MANDIBULAR |
$715 | $1,100.00 | |
| 5130 | IMMEDIATE DENTURE-MAXILLARY | $760 | $1,216.00 | |
| 5140 | IMMEDIATE DENTURE-MANDIBULAR | $760 | $1,216.00 | |
| 5211 | MAXILLARY PARTIAL DENTURE-RESIN BASE (INCLUDING ANY CONVENTIONAL CLASPS, RESTS AND TEETH) | $701 | $875.00 | |
| 5212 | MANDIBULAR PARTIAL DENTURE-RESIN BASE (INCLUDING ANY CONVENTIONAL CLASPS, RESTS AND TEETH) | $701 | $882.00 | |
| 5213 | MAXILLARY PARTIAL DENTURE-CAST METAL FRAMEWORK WITH RESIN DENTURE BASES(INCLUDING ANY CONVENTIONAL CLASPS, RESTS OR TEETH) | $798 | $1,205.00 | |
| 5214 | MANDIBULAR PARTIAL DENT-CAST METAL FRAMEWORK W/ RESIN DENT BASES (INCLUDING ANY CONVENTIONAL CLASPS, RESTS, AND TEETH) | $798 | $1,200.00 | |
| 5410 | ADJUST COMPLETE DENTURE-MAXILLARY | $38 | $62.00 | |
| 5411 | ADJUST COMPLETE DENTURE-MANDIBULAR | $38 | $62.00 | |
| 5510 | REPAIR BROKEN COMPLETE DENTURE BASE | $64 | $140.00 | |
| 5520 | REPLACE MISSING/BROKEN TEETH | $61 | $125.00 | |
| 5630 | REPAIR OR REPLACE BROKEN CLASP | $74 | $180.00 | |
| 5650 | ADD TOOTH TO EXISTING PARTIAL DENTURE | $64 | $155.00 | |
| 5660 | ADD CLASP TO EXISTING PARTIAL DENTURE | $82 | $190.00 | |
| 5730 | RELINE COMPLETE MAX DENTURE (CHAIRSIDE) | $153 | $257.00 | |
| 5731 | RELINE COMPLETE MAND DENTURE (CHAIRSIDE) | $153 | $258.00 | |
| 5740 | RELINE MAX PARTIAL DENTURE (CHAIRSIDE) | $145 | $253.00 | |
| 5741 | RELINE MAND PARTIAL DENT (CHAIRSIDE) | $145 | $255.00 | |
| 5750 | RELINE COMPLETE MAX DENTURE (LAB) | $200 | $336.00 | |
| 5761 | RELINE COMPLETE MAND DENTURE (LAB) | $200 | $330.00 | |
| 6240 | PONTIC PORCELAIN FUSED TO HIGH NOBLE METAL | $491 | $779.00 | |
| 6241 | PONTIC-PORCELAIN FUSED TO PREDOM BASE METAL | $451 | $701.00 | |
| 6242 | PONTIC PORCELAIN FUSED TO NOBLE METAL | $539 | $750.00 | |
| 6750 | CROWN-PORCELAIN FUSED TO HIGH NOBLE METAL | $515 | $775.00 | |
| 6751 | CROWN PORCELAIN FUSED TO PREDOM BASE METAL | $479 | $700.00 | |
| 6752 | CROWN-PORCELAIN FUSED TO NOBLE METAL | $490 | $750.00 | |
| 7110 | SINGLE TOOTH EXTRACTION | $61 | $100.00 | |
| 7120 | EACH ADDITIONAL TOOTH | $58 | $95.00 | |
| 7130 | ROOT REMOVAL-EXPOSED ROOTS | $76 | $140.00 | |
| 7220 | REMOVAL OF IMPACTED TOOTH-SOFT TISSUE | $125 | $224.00 | |
| 7230 | REMOVAL OF IMPACTED TOOTH-PARTIALLY BONY | $164 | $284.00 | |
| 7240 | REMOVAL OF IMPACTED TOOTH-COMPLETELY BONY | $219 | $350.00 | |
| 7250 | SURG REMOVAL OF RESIDUAL TOOTH ROOTS | $115 | $225.00 | |
| 7310 | ALVEOLOPLASTY IN CONJUNCT W/ EXTRACTIONS/QUAD | $105 | $200.00 | |
| 7320 | ALVEOLOPLASTY NOT IN CONJUNCTION W/ EXT/QUAD | $152 | $295.00 | |
| 7510 | INCISION/DRAINAGE OF ABSCESS-INTRAORAL SOFT TISSUE | $77 | $156.00 | |
| 8070 | COMP ORTHO TREATMENT--TRANSITIONAL DENTITION | 20% Discount |
$4,255.00 | |
| 8080 | COMP ORTHO TREATMENT--ADOLESCENT DENTITION | 20% Discount |
$4,308.00 | |
| 8090 | COMP ORHTO TREATMENT--ADULT DENTITION | 20% Discount |
$4,527.00 | |
| 9110 | PALLIATIVE TREATMENT DENT PAIN-MINOR PROCEDURE | $40 | $85.00 | |
| 9215 | LOCAL
ANESTHESIA |
$15 | $43.00 | |
| 9230 | ANALGESIA | $25 | $51.00 | |
| 9951 | OCCLUSAL ADJUSTMENT LIMITED | $56 | $127.00 | |
| 9952 | OCCLUSAL ADJUSTMENT COMPLETE | $227 | $487.00 | |
There is a one-time enrollment fee of $15 charged with your initial down payment. This fee schedule expires 12/31/2004.
|
UCR = Usual, Customary & Reasonable plus a 20% discount. All of the above charges are reduced fees for services performed by a participating
general dentist. Fee schedule subject to change without notice. Any procedure not listed is available on a fee for service basis at a 20% discount from the participating provider's fee schedule. Consult with your participating dentist prior to beginning any treatment. Fees do not include lab costs which are the members responsibility. Some services, at the discretion of the general dentist, may need to be referred to a specialist (advanced degree). Please see "Additional Specialty Services." The information displayed is for marketing purposes only. Additional procedures and benefits are covered but not shown.
Co-payments subject to change without notification. This fee schedule represents the primary plan available in your state.
Additional Specialty Services Any treatment provided by a participating specialist, if available, in Oral Surgery, Orthodontics, Periodontics, Pedodontics or Endodontics will be charged at a 20% reduction of participating specialist's fees for that particular case. Some specialists may require a consultation visit before treatment is initiated. Discuss each case with specialist prior to beginning any treatment. Implants and some whitening procedures will not be discounted by all participating CAREINGTON providers. Implants and some whitening procedures will only be discounted if the participating CAREINGTON provider has agreed to discount these procedures as part of their contract. These services will be offered, when applicable, at a 15% discount off of the provider's normal fee.
If the General Dentist's normal fee for any
procedure is less than the fee listed on this schedule, the dentist will charge
20% off of their normal fee for that procedure.
Plan Exclusions
(1) Work in progress is not covered. (2) Work in progress after enrollment on the dental plan must be completed before selecting another participating dentist. (3) Any dental procedures performed by a non-participating dentist are not covered. (4) We cannot guarantee the continued participation of any dentist. If he/she leaves the plan, you will need to select another dentist. (5) Not all types of dentists may be available in your area; you may have to travel to receive care from a participating general dentist or specialist. (6) Some providers may charge for missed or broken appointments with no prior notice. (7) Please verify that the dentist is a participating provider when scheduling your appointment. (8) Work in progress prior to enrollment on the dental plan must be completed by the dentist who started the work and is subject to no discount.
|
||||
