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NationalCare Dental $1,500

Plan Highlights
Annual Max $1,500

 

  • Preventive Services
    Type I - 100% Coverage
    No waiting period. No Deductible.
    Includes oral exams, cleanings, bitewing x-rays, and fluoride treatment. 

     
  • Basic Services
    Type II - 80% Coverage
    No waiting period. 
    $50.00 Individual deductible.
    Maximum Deductible per Family: 3 times the Individual

    Includes fillings, full mouth x-rays, restorative amalgams, composites, simple extractions, and sealants.
     
  • Major Services
    Type III - 50% Coverage
    12 month waiting period.
    $50.00 Individual deductible.
    Maximum Deductible per Family: 3 times the Individual

    Includes oral surgery, endodontics, complex extractions, periodontics, Onlays, anesthesia, dentures, crowns, bridges, and implants.

*Waiting period for Major services may be waived with proof of prior coverage provided by the member. Proof of prior coverage will only be accepted from the prior carrier within 30 days of the effective date on National Care Dental, and showing 12 months of continuous fully insured coverage with no lapse. DHMO, discount, or scheduled plan coverage will not be accepted. 

PRODUCT DETAILS

Type I 
Preventive Services
100%
Type II
Basic Services
80%
Type III
Major Services
50%
 

 


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National Small Business Association Benefits

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Health Care Discounts Disclosure

Not Available in AK, OK, UT, VT, WA. If you move to one of those states, your discount medical benefits will terminate. The discount medical, health, and drug benefits of this Plan (The Plan) are NOT insurance, a health insurance policy, a Medicare Prescription Drug Plan or a qualified health plan under the Affordable Care Act. The Plan provides discounts for certain medical services, pharmaceutical supplies, prescription drugs or medical equipment and supplies offered by providers who have agreed to participate in The Plan. The range of discounts for medical, pharmacy or ancillary services offered under The Plan will vary depending on the type of provider and products or services received. The Plan does not make and is prohibited from making members’ payments to providers for products or services received under The Plan. The Plan member is required and obligated to pay for all discounted prescription drugs, medical and pharmaceutical supplies, services and equipment received under The Plan, but will receive a discount on certain identified medical, pharmaceutical supplies, prescription drugs, medical equipment, and supplies from providers in The Plan. You may call (800) 656-2204 for more information or visit www.1enrollment.com/agmembers for a list of providers. The Plan will make available before purchase and upon request, a list of program providers and the providers’ city, state and specialty, located in the member’s service area. The fees for The Plan are specified in the membership agreement. Note to MA consumers: The plan is not insurance coverage and does not meet the minimum creditable coverage requirements under M.G.L. c. 111M and 956 CMR 5.00.

States Available

AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, IA, ID, IL, IN, KS, KY, LA, MD, MI, MO, MS, NC, ND, NE, NJ, NM, NV, OH, OK, OR, PA, RI, SC, TN, TX, UT, VA, WI, WV, WY


States Not Available

AK, HI, ME, MA, MN, MT, NH, NY, PR, SD, VT, WA
Product
$49.00 per Month for Member
$96.00 per Month for Member plus Children
$89.00 per Month for Member plus Spouse
$134.00 per Month for Family

Limitations and Exclusions

Covered Expenses will not include, and no benefits will be payable for, the following: 

 
  1. Expenses in any Class of services that are incurred during the insured’s waiting period for services in that class (as shown in the schedule of benefits). Except for expenses that may be provided under the takeover benefits provision following these limitations and exclusions provision. (An insured is not eligible for takeover benefits if takeover benefits are not provided, or if takeover benefits are provided but the person: (a) is a Late entrant; (b) became insured under the policy after the participating employer's effective date, or (c) was not insured under the participating employer's prior plan that was replaced by coverage under the policy.)
  2. Any treatment which is for cosmetic purposes, or to correct congenital malformations, other than medically necessary treatment of congenital cleft in the lip or palate, or both. In any event, an exception to this exclusion should be made for newborns, adopted children, and children placed for adoption.
  3. Replacement of any full or partial denture, fixed bridge, other appliance, crown, inlay, onlay, or other precious or semiprecious metal restoration within five years of the date of the last placement of the item. But, if a replacement is required because of an accidental bodily injury sustained while the Insured is covered under the policy, it will be a covered expense. In any event, replacement is not a covered Expense if the item can instead be repaired or otherwise restored to adequate function.
  4. Initial placement of any full or partial denture, fixed bridge, or other prosthetic appliance during any period of continuous coverage for the Insured under the policy, unless such placement is needed because of the extraction of one or more of the insured’s natural teeth during the same period of continuous coverage. Any portion of the expense that is identifiable as applying specifically to the replacement of a tooth extracted before that period of continuous coverage is not a covered expense. The extraction of a third molar (wisdom tooth) does not qualify the appliance for payment. Any such appliance must include the replacement of the extracted tooth or teeth.
  5. Addition of a new tooth or teeth to an existing full or partial denture, fixed bridge, or other prosthetic appliance during any period of continuous coverage for the Insured under the Policy, unless such addition is a replacement of a natural tooth or teeth extracted during the same period of continuous coverage. The extraction of a third molar (wisdom tooth) does not qualify the appliance for payment.
  6. Any expense incurred before the insured’s insurance under the policy starts; or any expense incurred during any period of continuous coverage for the Insured under this Policy if the procedure starts before the period of continuous coverage starts.
  7. Any procedure that starts, or any expense that is incurred (regardless of when the procedure starts), after the insured's insurance under this policy, ends. But, this exclusion does not apply for any denture, partial denture, fixed bridge, other appliance, crown, inlay, onlay, or other precious or semiprecious metal restoration if both: (a) the procedure starts while the insured's insurance under this policy is in effect, and (b) the expense is incurred within 90 days after the insured's insurance under this policy ends.
  8. Duplication of appliances, or replacement of lost or stolen appliances.
  9. Appliances, restorations, or procedures to (a) alter vertical dimension; (b) restore or maintain occlusion; (c) splint or replace tooth structure lost as a result of abrasion or attrition, or (d) treat jaw fractures or disturbances of the temporomandibular joint.
  10. Any procedure that is not shown on the list of dental procedures
  11. Education or training in, or supplies used for, dietary or nutritional counseling, personal oral hygiene or dental plaque control
  12. Charges for broken appointments or the completion of claim forms
  13. Sealants that are: (a) not applied to a permanent molar; (b) applied before attaining age 6 or after attaining age 16; or (c) reapplied to a molar within 3 years from the date of a previous sealant application
  14. Subgingival curettage or root planning (procedure numbers 4220 - 4342) unless the presence of the periodontal disease is confirmed by both x-rays and pocket depth summaries of each tooth involved
  15. Charges because of an insured’s injury arising out of, or in the course of, work for wage or profit
  16. Charges because of an insured’s sickness, injury or other condition for which he or she is eligible for benefits under any Worker's Compensation Act or similar laws.
  17. Charges for which the insured is not liable, or which would not have been made had no insurance been in force.
  18. Services that: (a) are not recommended by a dentist; (b) are not required for necessary care and treatment, or (c) do not have a reasonably favorable prognosis
  19. Charges because of an insured’s sickness, injury or other condition due to war or any act of war, declared or not, or sustained while on full-time active duty in the armed forces of any country.
  20. Benefits payable to an insured if payment is not legal where the Insured is living when expenses are incurred.
  21. Services related to equilibration; bite registration or bite analysis.
  22. Crowns for the purpose of periodontal splinting
  23. Charges for: overdentures, precision or semi-precision attachments and associated endodontic treatment, any other customized attachments, or any specialized prosthodontic techniques or characterizations.
  24. Charges for: myofunctional therapy, orthognathic surgery, or athletic mouthguards.
  25. Procedures for which benefits are payable under the Participating Employer’s medical expense benefit plan for employees and their dependents. See the coordination of benefits provision for an explanation.

TAKEOVER BENEFITS. Takeover benefits are provided only if so indicated in the schedule of benefits. If takeover benefits are provided, an insured is eligible for takeover benefits only if the person both: (1) was insured under the participating employer’s prior plan the day before the participating employer’s effective date under the policy; and (2) has been continuously insured under the policy since the participating employer’s effective date. If takeover benefits are provided and the insured is eligible for takeover benefits, then we will reduce the insured’s waiting period(s) by the length of time, ending on the day before the participating employer’s effective date, that the insured was continuously covered for similar classes of service under the participating employer’s prior plan.

 

 

Standard 1-5 business days $7.95
Two Day 2 business days $15
Next Day 1 business day $30
* Free on orders of $50 or more