Surbridge Prime Dental DVH Plan
Plan Year:
2022
Health Insurance Carrier:
Surebridge
Cleanings are covered 100%. There is no waiting period for basic work (cleanings and fillings) and only a 9 month waiting period for major work (crowns and root canals, etc.), then you get 60% covered after the $100 deductible per person. There is a maximum benefit of $1000 per person per year. The vision portion reimburses your exams 100% and has a 9 month waiting period to reimburse you for glasses or contacts. This plan will reimburse 60% up to $200 for your contacts or glasses. The benefits of this plan increase every year. The second year you get 70% coverage and the 3rd year it maxes out at 80% coverage. This dental insurance does not include coverage for orthodontics.<BR><BR>You can choose ANY provider in the US and receive coverage. You will pay less if using in network providers. Please go to the SureBridge Network Search link on our website to find a provider: utahavenue.com/single-post/does-my-dentist-take-my-dental-insurance If your dentist is not listed, the plan will still cover you! Let your dentist know your insurance has out-of-network benefits. They will need to send in the bill as out-of-network charges.
Snapshot of benefits
This is a quick snapshot of the most popular copays, deductibles, and coinsurance that you would be responsible for on this dental plan. Preventative services include dental cleanings, exams and x-rays. Most plans cover your preventative care every 6 months with no waiting period. Basic dental work includes minor services like filling a cavity and may have a waiting period before these services will be covered on your plan. Major work includes services like crowns and root canals and may have a waiting period before these services are covered. Dentures and implants are normally NOT included in dental insurance. If you need coverage for these services, please let your local agent know so that you have a plan that includes those services.
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To learn what each of the below terms mean, please visit our terms and definitions page. Copays and coinsurance listed are amounts that you would pay before deductible unless specified otherwise. This is not a full list of services included on the plan. This snapshot is not guaranteed to be accurate. To verify plan benefits or for full details please see the full summary of benefits or or get a complete terms of coverage on the health plan carrier's website.
Preventative:
Typically includes cleanings, exams, x-rays two times per year. Fluoride is usually only covered for children under 18. See full summary of benefits to see what is included in preventative services. Some x-rays have limitations on coverage.
Minor Services:
Typically includes cavity fillings, simple extractions (on some dental plans), consultations, and denture adjustments (on some dental plans). See full summary of benefits for limits and exclusions.
Major Services:
Typically includes deep sedation, crowns, root canals, oral surgery, periodontics, endodontics and dentures (on some dental plans). See full summary of benefits for limits and exclusions.
Service
In-Network
Out-of-Network***
Individual Deductible
Family Deductible
Preventative Care
Preventative Waiting Period
Minor Services 1st year benefit
Minor Services 2nd year benefit
Minor Services Waiting Period
Major Services 1st year benefit
Major Services 2nd year benefit
Major Services Waiting Period
Implant Coverage
Denture Coverage
Annual Maximum 1st Year Benefit
Annual Maximum 2nd Year Benefit
$100
$100 per person
100%
None
60%
70%
None
$100
$100 per person
100% of fee schedule
None
60% of fee schedule
70% of fee schedule
None
60%
70%
9 Month
See full summary of benefits
See full summary of benefits
$1,000
$1,000
60% of fee schedule
70% of fee schedule
9 Month
See full summary of benefits
See full summary of benefits
$1,000
$1,000
Vision Benefit
Prime DVH has a maximum vision benefit of $200 / year. Eye exams are covered 100% without a waiting period. The plan pays 60% towards contacts or glasses the first year after a 9 month waiting period, 70% the second year, and 80% thereafter, subject to the policy maximum. This is a reimbursement plan, you can see any eye doctor and then submit your paid receipts for reimbursement up to the policy limits.
Hearing Benfit
Prime DVH has a maximum hearing benefit of $500 / 2 years. Hearing exams are covered 100% up to $75 per year without a waiting period. The plan pays 60% towards hearing aids and repairs the first year after a 9 month waiting period, 70% the second year, and 80% thereafter, subject to the policy maximum.
***Out of Network Limitations and Balance Billing
Some dental plans offer out of network coverage. This is a great benefit because you can visit any dentist in the nation. Which means that if you are traveling, or have a dental emergency, you can visit a dentist for the service you need right away and have a portion of your bill covered by your dental insurance. Please note that if you see an out of network provider, that dentist is allowed to "balance bill" you. This means that your dental insurance company pays your dentist what is reasonable and customary for the services you received. In most situations that dentist accepts that payment and you are only responsible for your portion of the bill. Occasionally, that dentist will decide that the reasonable and customary amount they received from the dental insurance is not enough. That dentist will bill you for the additional charge or 'balance bill' you. You are responsible to pay this amount or contact the dentist to work out a payment plan.
Frequently Asked Questions
How do I get my ID card?
You'll receive your ID cards in the mail about two weeks after you sign up for this plan. Be on the lookout in your mail box for an envelope with the company's logo on it. You can also download and get a digital copy of your ID card in the member portal. Visit the website below or download the member portal app on your phone. If you need to see a provider before your ID cards arrive in the mail, your dental office will be able to look up your plan with your name and birthday. You can also call or text our office and we will help get you the right information.
Is your dentist in network?
Here you can search on the provider's website to see if your preferred dentist is in network. Some dental plans include out of network coverage so you can visit any dentist for services. But be aware of balance billing as described above. Have questions or need help searching for the right dentist? Please feel free to reach out to your agent. We're happy to help with this for free.
Currently Enrolled with this plan? Log into your portal.
Below is the link to log into your client portal. Most companies have an app you can also download onto your phone. The best place to view information about your health insurance is through the member portal. The member portal gives you easy access to your plan details, claims information, deductible and out-of-pocket details, ID cards, and more. You can update your payment information in the member portal, too. Simply set up an account and login by clicking the member portal link below. If you have any issues logging in, just give us a call and we can help.
Premium Payments
Premium payments is the monthly amount you pay for your health insurance plan. It is usually due on the 1st or 15th of each month. The initial premium, or binder payment, needs to be made before your plan starts. Be sure to watch your account to make sure the premium has been debited. Most carriers accept bank accounts, debit cards and credit cards as payment. If you need to update your account, you can log into your portal or call our office for help.
Deductible? Copays? Coinsurance? What does it mean?
Learn the basic terms about health insurance to better understand your plan. Don't worry, most people don't know what these terms mean and how they apply to your plan. That's why we're here. Please contact us if we missed any terms or if you'd rather talk to us instead of read.
Learn more about this plan
Find out if you qualify for subsidies (lower monthly premiums). Most families do qualify for lower premiums. Get a quote for you and your family or book an appointment with a local Utah health insurance agent. You can book a phone, virtual or office appointment.
Schedule a consultation with a local Utah health insurance agent
We're happy to meet with your in-person or over the phone to help you with your health insurance needs. We can help you with health insurance on or off the marketplace, Medicare Advantage & supplements, dental insurance, vision insurance, life insurance or accident plans. Thank you for letting us be your advocate. Best part, is our help is always free!
