United Health Care Dental Provider Search – United HealthOne is the largest single healthcare provider in the country. Because of this, they offer great dental insurance options for Indiana residents
More dentists in a provider network means you’re more likely to keep the dentist you use today and also have coverage available while traveling. Network providers agree to accept negotiated rates.
United Health Care Dental Provider Search
Your eyes are also an important part of your health. You can add vision benefits (available in most areas for an additional premium) to your dental plan. Coverage for eye exams to contact lenses. Add today for additional coverage.
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There is no waiting period for preventive care, and depending on the plan design, you pay a $25 copay or nothing at all. For basic and major services, there is a maximum of 3 individual $50 deductibles per household, per calendar year. Our Premier plans offer combined deductibles for basic and major services – especially useful for large families.
No age limit means even those covered by Medicare can apply. Good dental health is important at any age. We plan to fit your age and life stage.
UHC offers four plan designs. “Primary” plans have a lower maximum benefit (annual payout cap), while “Premier” plans have a higher benefit that increases over time. From them, you can choose the plan that suits you best depending on whether your doctor is in network or not.
All Plans: Preventive Services Preventive services are covered without deductibles, coinsurance or waiting periods. Dental Primary and Dental Primary Preferred have a $25 copay for preventive services.
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Premier Priority, Premier Choice and Premier Elite plans only: Major services (limited in policy) Major services are subject to deductible, coinsurance and waiting period. Not available with all plans. Major services have a waiting period of 12 months. • Root Canals – Limit 1 time per tooth, per lifetime. • Treatment of gum disease. • Crowns – 1 per tooth, limit per 60 months. • Surgical extraction. • Complete Denture – Limited to 1 per 60 months. • Bridge – limited to 1 time per tooth, every 60 months. • Repair of crowns, teeth and bridges. • Oral surgery. • Inlays/Onlays – Limit 1 per tooth, per 60 months.
Change of residence or misstatement (address) You must notify us within 60 days of your change of residence. Your premium based on your new residence will start from the first due date after the change. If you have incorrectly stated your residence on the application or failed to notify us of a change of residence, we will apply the appropriate premium to the first payable date on which you resided at that residence. If the change results in: a lower premium, we will refund the excess; The higher the premium, the more you owe us.
Network providers agree to discounted prices for covered costs, in which you are not billed for anything extra other than copayments, coinsurance and deductibles. You can obtain the following information: 1) provider status by calling the toll-free telephone number on your ID (or at myuhc.com); and 2) out-of-pocket expense information by calling the claims number listed on your ID card. Premium You will be given at least 31 days notice of any change to your premium. We will not make any change in your premium due to a claim made by a person covered under the policy. Reimbursement If the dental services are caused by the acts or omissions of a third party, we are entitled to reimbursement to the extent of the benefits payable by us for the dental services as specified in the policy. The term of the renewability policy starts from the effective date of the policy. You can keep the policy in force by paying us the required premium as it becomes due. Your policy auto-renew as long as the premium is paid. However, we may cancel the policy if fraud or material misrepresentation is committed by or with the knowledge of a covered person while filing a claim for benefits. Termination The policy will terminate: • If you fail to pay the premium subject to the grace period defined in the policy; • on the date you request; • If we refuse to renew all policies issued on this form, the same type and level of benefits in your residence; or • on the date of your death, if your spouse is not covered by the scheme.
Dependents Eligible dependents are your legal spouse and eligible children. Eligible children must be unmarried (and under 26 years of age at the time of application. Effective Date
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For an application sent by electronic means, the effective date shall be the later of: (i) the requested effective date; or (ii) the day after receipt by Golden Rule Insurance Company (GRIC). For mailed applications, the effective date shall be the later of: (i) the requested effective date; or (ii) the U.S. day after the postmark date by the Postal Service. If the U.S. If mailed by the Postal Service and not postmarked or if the postmark is not legible, the effective date shall be the later of: (i) the requested effective date; or (ii) date received from GRIC. Health insurance for dental expenses If a covered person has other dental or health insurance that pays for expenses covered by the policy, we will not pay until we first determine which benefits are covered by the other policy. Our payment will be reduced by the amount paid by other schemes. Non-Network Vs. Network Providers Warning: You will pay more for non-emergency services using non-network providers. Non-network providers may bill you for any amount up to the billed fee after paying part of the plan. Your benefit coverage will be determined by your policy’s non-network provider reimbursement.
• Replacement within 60 consecutive months of last placement for complete and partial dentures, and replacement within 60 consecutive months of last placement for crowns, bridges, inlays, onlays and veneers. This exclusion does not apply if replacement is required due to extraction of a functioning natural tooth; or the current crown, bridge or denture is temporary and a permanent crown, bridge or denture is installed within 12 months from the date of installation of the temporary service. • Replacement of crowns, bridges, dentures and fixed or removable prosthetic devices worn prior to the plan coverage unless the covered person has been insured under the plan for 12 continuous months. If teeth are lost during this 12-month period, dental services related to adjuncts will be covered if the addition of an abutment, pontic and/or abutment(s) is required, when the service is a covered expense. • Replacement of complete dentures, fixed and removable partial dentures or crowns if loss or breakage is directly attributable to provider error. This type of replacement is the dentist’s responsibility. If your or your dependents’ non-compliance requires replacement, you are responsible for replacement costs. • Fixed or removable prosthodontic restorative procedures for full oral rehabilitation or reconstruction. Select your plan’s network from the selection below. You can find your network on your ID card. Or find the type of plan you have and select the network listed under Plan Selection.
Network availability may vary by state and the contract status of a particular healthcare provider may change at any time. Additionally, only listed office locations are within your network. Visiting a doctor at any other location may reduce benefits. So, before you seek care, you should check with the health care provider that he or she is still contracted with your network and the location where you plan to visit the doctor.
Please note, providers are not required to accept revalued amounts for rejected charges (unless otherwise stated in their contract). In the past, LabCorp regularly accepted re-price amounts on rejected charges. But since then they have changed their policy and are no longer accepting revalued amounts for rejected charges from 10/01/18.
Ucr Vs Mac Dental Plans. What’s The Difference?
California Medical Necessity Review Process for Mental Health: Licensed nurses conduct an initial clinical review for pre-service, concurrent and/or post-service/antecedent requests using clinical review criteria consistently to determine the medical necessity of mental health services. All requests that cannot be validated through the initial review are referred to a clinical peer for determination. The reviewer will only request information necessary to make a decision.
In the case of a pre-service or concurrent care review, a decision not to approve a service based on medical necessity will be made within 5 business days of receiving the information reasonably necessary for the review. A decision on completed services will be made within 30 days of receiving the information reasonably necessary to conduct the review. Urgent reviews will be conducted when the insured’s condition is such that they pose an imminent and serious threat to his or her health or the insured’s ability to regain maximum function. Expedited review determinations will be completed within 72 hours of receipt of reasonable information
