Dental, Vision & Hearing

How Does Dental Insurance Work?

Dental insurance works in much the same way that medical insurance works. For a specific monthly rate (or "premium"), you are entitled to certain dental benefits, usually including regular checkups, cleanings, x-rays, and certain services required to promote general dental health. Some plans will provide broader coverage than others and some will require a greater financial contribution on your part when services are rendered. Some plans may also provide coverage for certain types of oral surgery, dental implants, or orthodontia.

What Is The Best Dental Plan For Me?

Although there is no one "best" dental insurance plan, some plans may work better for you and your family than others. Plans differ primarily in how much you'll have to pay monthly for your coverage and how much you'll have to pay when dental services are rendered. Some plans will require that you pay a certain co-payment for services, or meet a specific deductible before the dental insurance company begins payment. Other plans may limit coverage to a specific dollar-amount maximum per year.

When reviewing your dental insurance options, here are a few questions to ask yourself:

  • How much will it cost me on a monthly basis?
  • Will I be required to meet a deductible? Once the deductible is met, how much will the dental insurance provider pay for my services?
  • What dentists participate in the plan's network? Are these dentists that my family and I would like to see?
  • If I used a dentist outside the plan's network, how much will I have to pay?
  • Are there waiting periods for certain procedures?

Vision Plans

Vision Insurance is generally a supplemental insurance to other types of medical insurance policies. It will help offset the cost of routine checkups as well as help pay for glasses and contacts.


These FAQs are not state specific, and are only meant to provide you with an overview.

I usually see dental by itself. Why should I get a plan with dental, vision, and hearing lumped together?

Dental Vision Hearing Plans are designed to meet as many needs as possible. Since it does not coordinate benefits, you may have an additional dental or vision plan. You may use parts of all of the coverage each year, or use all of your benefits towards one area. This plan offers versatility that you cannot got with dental alone.

Is this a discount plan or insurance?

This is a Limited Benefit Insurance policy. That means it is a medical plan with restricted benefits, but lower premiums.

How do these plans typically work?

After the yearly deductible has been satisfied, then the following percentages will reimburse expenses up to yearly max.

  1. 60% - first policy year
  2. 70% - second policy year
  3. 80% - third policy year and thereafter.

*Some states may vary.

What is the annual max?

It is the maximum amount of money the policy will pay out during your policy’s year, from your personal start date to the next. You may select either $1000, or $1500.

Is there an age limit?

In most states, enrollment ends at the age of 85. There is no termination by age, so you may keep your policy as long as you pay your premiums.

When can I start using this?

Immediately. However, some services do have a wait period.

We will not pay benefits for the following in the first year: endontics (including root canals), periodontal surgery, bridges, crowns, full dentures or partials, any work relating to replacement of natural teeth which were missing at the time coverage becomes effective, “full mouth” extractions, fluoride treatments, outpatient dental surgery, hearing aids, including repairs.

Is there a deductible?

Yes. $100 per policy year.

Can I have health coverage with a different company than my dental coverage?

Yes. This plan is a versatile product that can be used with or without another plan from any company.

Can I use this with another dental plan?

Yes. This plan does not coordinate benefits.

Must I have health insurance to have a dental plan?


How do I know if I’m eligible for this plan?

This plan is guaranteed issue. However, you must meet the age requirement.

Can I become ineligible?

No. This plan guarantees renewability for the life of the policy, so long as the premiums are paid on time.

Does this plan cover any pre-existing conditions?

Yes, but all pre-existing conditions, whether disclosed in the application or not, are subject to a twelve- month waiting period.

How does this work with my Medicare?

It has no effect with your Medicare since it does not coordinate benefits.

Can I keep my dentist?

Yes. This is a reimbursement plan.

How often will my premium change?

Premiums are subject to change at any time.

Does this cover braces or orthodontics?

Unfortunately, no. This is a limited benefits plan, so to keep premiums low some services will not be covered.

Is tooth whitening covered?

No, this is a cosmetic procedure and is not covered by this policy. If a dentist were to rule it medically necessary, it could be covered.

Can I get my wisdom teeth extracted?

Yes, unless you receive the diagnosis that they are impacted.

Can I use the Vision component for my cataracts or Lasik surgery?

Unfortunately, no. This is a limited benefits plan. To keep premiums low some services will not be covered.

Can I get a hearing aid?

Yes, after the 12 month waiting period for new, or repairs to hearing aids.

For more information about our firm and the services we offer, send us a quick email or call the office. We would welcome the opportunity to speak with you. | 800-741-1643