The first plan is the Standard Plan A or Plan B is their primary plans. They adjust their deductibles and coverages depending on how you feel your budget is. Plan A has $1000 year max, $50 deductible, and a one year waiting period for major services.
Review of the Stonebridge Dental Plan (cont).
One hundred percent paid for preventative and 50% for basic and majors services. Plan B has $850 year maximum benefit, $50 deductible same waiting periods as plan A but all coverages paid out at a 50% rate. You can see how Plan B would be less expensive but also has lower coverages.
The next Encore plan would be there 1-2-3 Insurance plan which features no waiting periods. Great for people that have basic and major needs now. They call it 1-2-3 because their coverage under the plan gets better each year you continue to maintain the plan. Therefore as an example the maximum limit starts the first year at $500, second year $750, third year $1200.
The Longer You Stay the Better it Gets
Their coverages progressively increases as well. A benefit of a plan like this is that they not only address your current needs but is designed to address your long term needs by increasing the coverage and maximum the longer you have the plan.
Lastly, they have the Supplemental Insurance Plan. It is designed to do just what the name states.
It is a plan that help eliminate the out of pocket expenses you may typically have to pay. It’s features would be only a six months waiting period on majors, 50% coverages for services, $50 deductible, and the annual year maximum is $1250.
The Supplemental Plan
This plan is designed to work with your primary insurance which will be a coordination of benefits helping to ensure you get the maximum amount of coverage allowed without duplicate payments. In short if you are wanting dental insurance and not a discount plan. Or you want to be able to stay with your dentist then all the plans stated above will aloud you to do so.
Pro and Cons of the Encore Dental Plan
Main pros about the Encore plans: You can use their plans for dental care at your own personal dentist, or you are free to choice from any of their 80,000 network dentist. If you use their network dentist you are guarantee the pre-negotiated prices. Therefore using the plan providers will avoid having any claims form hassles.
Main Cons: If you go to a dentist not in their network you do not have any guarantee about what the dentist will charge for their service therefore you may run into an Usual, Customary, Reasonable (UCR) issue.
A Final Note on Encore
When you use a dentist who is not in the network, you may have to pay the full amount at the time of service and submit a covered claim to Encore. Encore will then send you a check for the amount your plan covers. This is something to keep in mind when planing out your dental needs.
Another con is that they are not in every state. The the states I was able to find them in was: CA, TX, OH, WS, MI, MO,IL and IN. Thus, as long as you bought the plan in a state Encore sells their plan in you can move to a different state and they will still maintain your plan.
If you would like more information about PPO’s then please visit InsuranceCompany.com