Insurance Programmers offers a wide variety dental insurance plans, and the type of plan you have depends on the contract your employer signed with them. Many of the plans follow similar structure – but yours may have specific conditions and exclusions not found in any other.
Annual Maximum Benefit –
Is what your insurance will pay in any given insurance year. For Insurance Programmers, it is typically between $1500 and $2500. Most Insurance Programmers Plans define INSURANCE YEAR from January 1 to December 31. Some plans, especially for school employees, may run on July 1-June 30 year. Check with your plan.
Annual Deductible –
what your insurance plan wants you to pay before they cover anything. For Insurance Programmers, it is usually $50.
Coverage for Preventive procedures – what your insurance plan will pay for checkups, cleanings, X-rays, and sealants and fluoride for children. It is typically 100%, although some plans may pay less. Usually, the deductible does not apply.
Coverage for Basic procedures – what your insurance plan will pay for fillings, root canals, gum treatments, and extractions. Most Insurance Programmers plans will cover 60-80% of the procedure costs. Sometimes, even though the plan says they will cover 80% of the procedure, their fees are so low that the actual coverage may be less.
Coverage for Major Procedures –
crowns, bridges, dentures. Typically, it is 50%, but it is subject to many provisions and restrictions, such as missing tooth clause, alternative minimum benefits, and others.
Coverage for Cosmetic Procedures –
veneers, teeth whitening, cosmetic bonding, adult orthodontics. No Insurance Programmers plan we have seen provides any coverage for these procedures.
Coverage for Dental Implants –
varies greatly by the plan. Check with your carrier for specific information.
Please keep in mind that your plan may be completely different from the general guidelines we have provided here. We use a sophisticated computer system, Dentrix with Trojan Insurance Module, to help us get as much information as possible. Very often, we are able to tell you about your plan in great detail once we know who the employer is. Call us at 914 630 2833 for more information.
Some of the companies and organizations in and around Westchester County who offer Insurance Programmers Dental to their employees and members are:
Eastchester Teachers Associatio
Mount Vernon Hospital
White Plains School Dist