SelectHealth Fundamental 1000 Dental Plan
This dental plan has a $50 deductible per person. Cleanings are covered 100% after deductible. It has 6 month waiting period for minor work and a 12 month period for major work. Minor work is covered at 80% after deductible and major work is covered at 50% after deductible. There is a $1000 maximum benefit per person on this plan each year.
The company that provides and manages your insurance coverage. You pay your insurance premiums, which are regular payments to maintain your coverage, directly to the carrier.
A dental plan year typically spans one year from when you enrolled in the plan. At the start of each new year, plans reset, and any deductibles, out-of-pocket maximums, and benefits calculations begin anew.
Individual and Family Deductible
Dental insurance plans offer individual and family deductibles to accommodate varying needs. Individual deductibles require a specific out-of-pocket payment before insurance coverage applies to dental procedures, while family deductibles consolidate these costs for the entire family's dental expenses.
These plans typically categorize dental work into minor and major procedures. Minor work covers routine treatments like fillings and simple extractions, with insurance sharing the cost. In contrast, major work, which includes procedures such as root canals or crowns, often requires a larger patient contribution. It's important to note that the deductible normally doesn't apply to preventative care, such as check-ups and cleanings, which are often covered at no cost, emphasizing their role in maintaining oral health without additional financial burden.
A deductible is the amount you pay out of your own pocket before your insurance coverage starts. It's a way to share costs between you and the insurance company.
Family deductible is the amount the entire family, or everyone enrolled on the plan, must meet before insurance pays a portion of your covered services.
Minor Dental Services
Major Dental Services
Orthodontia for Children
Maximum Yearly Dental Benefit
Full Summary of Benefits and Helpful Links
Official documents, such as your insurance policy or Summary of Benefits and Coverage (SBC), outline the details of your coverage, including deductibles, copayments, and covered services. Provider links, often available through your insurance company's website, offer directories of in-network healthcare professionals and facilities, helping you find the right doctors and hospitals that are covered by your plan. Utilizing these resources can empower you to make informed healthcare decisions and effectively navigate your insurance coverage.
Schedule a consultation with a local Utah health insurance agent
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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.
To learn what each of the terms mean, please visit our terms and definitions page. Copays and coinsurance listed are amounts that you would pay after 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.
***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.