Changing Dental Carriers?
If my current dentist is not in the Ameritas network, will I pay significantly more for dental services?
We regularly analyze dentist procedure charges from every ZIP Code to come up with U&C levels for each area. When you visit an out-of-network dentist, the amount that we reimburse you or your provider is based on what 9 out of 10 dentists’ charges for that procedure in your given three-digit Zip Code area. So your dentist’s charges are very likely to be at or below what our plan pays. If your dentist’s charges happen to be higher than the 90th U&C allowance, the difference will be an out-of-pocket expense. You can ask your provider to submit a pretreatment estimate to Ameritas so you and your provider can see exactly how the claim will be processed and what you will pay.
How will switching carriers to Ameritas impact dental treatment that’s in progress?
Dental treatments are billed based on the date each service is performed. For example, the day your provider starts a root canal or prepares a crown or denture is considered the date of service. If you have a service in progress that requires multiple visits, claims for services received before January 1, 2019 will be submitted to your previous dental carrier. Claims for dental services performed January 1 or after will be submitted to Ameritas. Ameritas does not have access to your claim history prior to January 1. Some services go hand-in-hand, such as a tooth extraction and replacement. If a tooth was extracted under prior coverage, you have 12 months after the date of extraction to replace the tooth under Ameritas coverage. If those services are performed under different coverages, your dentist should provide documentation of the previous procedure, and Ameritas may request further information from you.
What if I’m in the middle of orthodontic treatment when the switch to Ameritas happens?
For orthodontic programs that were covered under your plan last year, and are in progress, Ameritas will coordinate benefits between the old plan and the new plan to make sure members get the remaining maximum benefit. For example, if the old plan had paid $750 toward your orthodontic treatment plan, you would still be eligible for an additional $1,250 under the Ameritas plan. Ameritas reimburses orthodontic payments quarterly. We encourage you or your orthodontic provider to contact Ameritas with any questions you may have. The following example shows orthodontic benefit payments under the Ameritas High Plan ($2,000 lifetime maximum) for a patient who paid $750 last year under the prior plan.
Search Network Providers
The network provider listing includes general and specialty practices, and lets you know if the provider is accepting new patients. You can request a map and driving directions to the provider’s office. Check the provider profile for office hours.
Don’t see your dentist on the network provider list? Let us know. Once you’re a member, you can nominate your provider to join the network. Just visit ameritas.com, log in to your secure member account, and select Nominate a Provider.