MA/Dental Coverage
- Thread starter wolf5150
- Start date
- 31,270
Yes, you can have multiple dental plans. There's a Forum member that has carried as many as 4 at once (LD).
Starting next year nearly every dental with the big carriers incredible. It's a bucket of money compared to the old days of copays and co ins . United will your benefits imbedded in 1 card with your otc, medical and food card . You can go to any dentist. So let's say you go to your dentist and the bills $800 . Usual and customary is $600 .United pays $600 and you pay the $200 . Much better than a dental lam that pays 50% on a major exp . This is a big big big selling pt .
- 31,270
Manhattan has a bucket of money DVH and pays more than 50%.
thats what $50 a month ? I'm saying for mapd clients this is big
- 31,270
More for the $3 K plan. I was just pointing out that there are stand alone plans that pay more than 50% on Major.
It's a bucket of money for 100% of all usual and customary charges up to $1500 a yr ? What are waiting periods for basic and major ? It's a scaling % up to year 1 and 2 ?See any dentist ? Will the dentist file the claim ?
- 31,270
After $100 deductible it pays 60% 1st year, 70% 2nd year and 80% 3rd year and thereafter of Usual and Customary charges(used to be actual charges). $1,000/$1,500/$3,000 annual max. Go to any Dentist, but they have Careington network if you want to save some more. If the Dentist won't file for you, send the bill in manually. I haven't heard of a Dentist not filing. No wait on Preventive, Basic, eye exams or hearing aids. 6 month wait on glasses, 12 Month wait on Major and hearing aids(they say they'll cover the OTC hearing aids.
I'm finding out usual and customary can be BS . I have met life dental cobra threw a ex wife and about to expire at yr end . $108 for a cleaning which is dirt cheap and they said usual and customary is $100 . I bet the avg cleaning $140 . So usual and customary can be way below . Do you know any individual plans that will waive preexisting waiting periods because I had prior group coverage ? I know I've seen some .
- 31,270
NCD (Sam, the Forum owner, is the CEO)
Fri, Aug 5 at 12:01 PM
We know the Take Over Benefits/Proof of Prior Coverage policy isn't super EXCITING to talk about.
But it's definitely an important aspect of what makes our plan one of the best in the industry, so we felt it was important to MAKE SURE you saw it.
If you have any questions, please reach out to Agent Support!
The Plans That Qualify:
- Prior coverage must be a PPO, EPO, MAC plan or Medicare Advantage plan dental rider.
- Yearly maximum benefit must be at least $1500.
- Coinsurance must be at least 50% on in-network major services.
- DHMO's, discount plans, scheduled benefit plans, and Medicare Advantage embedded plans DO NOT QUALIFY.
- AT TIME OF SALE
- Fill out the 5 easy questions on the application.
- Recommend to your client to request a letter of coverage and schedule of benefits from their prior carrier.
- AFTER THE SALE
- Get the schedule of benefits and letter of credible coverage on the previous carriers letterhead.
- Documentation must be provided within 5 days of request (if audited) with the following information:
- Carrier Name
- Effective Dates of Coverage
- Termination Dates of Coverage
- Covered Member Names and Birth Dates
- Member ID Numbers
- Covered Benefits
- There cannot be more than 1 month (31-day) break in coverage.
We hope that this policy simplification makes your job as an NCD Agent easier. We always want to Spread The Smile to agents, so you can Spread The Smile to current and future members.
We recommend you review the entire policy by clicking the link below.
Click Here For Full Policy
You can also contact our Agent Support Team with any tricky situations.
agentsupport@ncd.com
Call Us
1 (844) 284-4944
Text Us
(469) 425-8419
