Customer Dental Plan FAQ

Once enrolled, access your dental benefits at your convenience in your member account online or the Ameritas Benefits app.

The frequencies of covered procedures are determined by your policy. Access your benefit information in your member account or contact us.

Each person has unique health needs. If your dental provider recommends additional cleanings or services not covered by your policy, those will be an out-of-pocket expense. Network provider discounts may apply to reduce your costs.

Your dental plan may provide coverage for oral surgery. A pre-operative X-ray is required to review a surgical extraction because benefits are subject to consultant review. Refer to your certificate of coverage, which can be found in your member account.

We recommend a pretreatment estimate for all dental work that you consider expensive. The estimate helps you know beforehand how much your plan can cover.

We also suggest submitting your oral surgery claim to your medical plan first as some medical plans have benefits for surgical extractions and general anesthesia or IV sedation.

A missing tooth clause explains any coverage limitations related to teeth missing or extracted prior to your effective date of coverage. The missing tooth clause can vary depending upon your plan, so be sure to check your certificate of coverage in your member account for details.

A sealant is a plastic material that is applied to the chewing surfaces of the back teeth (premolars and molars) where decay occurs most often.

Thorough brushing and flossing help remove food particles and plaque from smooth surfaces of teeth, but toothbrush bristles may not reach all the way into the depressions and grooves to extract food and plaque. Dental sealants act as a barrier, protecting the teeth against decay-causing bacteria.

Group dental plan member: Open enrollment is your opportunity to review your benefit coverage. If your benefits administrator offers a choice of plans, you may choose the plan that best fits your needs. You also can make changes when there is a qualifying event, such as marriage, divorce or legal separation, birth of a child, loss of employment, new employment, or death of an insured member. Contact your benefits administrator with questions on your dental plan options.

Individual dental policyholder: As an individual policyholder, you may change or cancel your benefits at any time. Contact the Sales Connect team at salesconnect@ameritas.com or 888-336-7601 to discuss options that best fit your needs. Dependent coverage can be adjusted in your member account.

Some dental plans define a time period, called an elimination period, that begins on your effective date. This must be satisfied before benefits on certain procedures become available. Because elimination periods are sometimes called waiting periods, care should be taken not to confuse the two.

If you enroll in a group dental plan more than 31 days after becoming eligible, you are considered a late entrant. There may be benefit limitations set by your benefits administrator and insurance carrier. Refer to your certificate of coverage in your member account for details.

In accordance with the Health Insurance Portability and Accountability Act (HIPAA), we are required by law to maintain the privacy of our insured members’ and their dependents’ protected health information. If you are an insured member, the privacy law allows you to obtain benefit information and claim status on all individuals insured under your dental policy. If your spouse is on the policy, he or she is allowed to obtain information on dependents under the age of 18. If you’d like to authorize others to access benefit information, complete and mail the Privacy Form to:

Privacy Office
PO Box 81889
Lincoln, NE 68510

All services under our plans are covered when appropriately delivered through teledentistry services. They are subject to the same plan benefits and limitations as equivalent services that are not provided through teledentistry.

There are many words you may not be familiar with related to your dental health and plan benefits. Browse our glossary to find definitions of many common terms.

Some dental plans provide coverage for hearing care. If hearing benefits are part of your dental plan, they will be shown in your dental certificate of coverage in your member account.

Your hearing benefit ID card will be with your dental ID card in your account and accessible in the Ameritas Benefits app.

Some dental plans provide coverage for laser vision correction. If LASIK benefits are part of your dental plan, they will be shown in your dental certificate of coverage in your member account.

After your effective date, new hire or other applicable waiting periods, you may begin using your benefits. If you are unsure, contact us to verify eligibility.

You are always free to visit any dentist. You may benefit from lower out-of-pocket costs when you visit one of our network providers.

To review your plan benefits and network information, access your dental benefit summary or certificate of coverage in your member account. Contact us if you have questions on how your dental provider choice may impact benefits.

Search for your dental provider in the provider directory.

You may be responsible for your deductible and copayment or coinsurance. However, some dental offices will not collect these until after the claim as been processed by insurance. Contact your dental office to ask how their billing process works.

If you have an ID card, you can take it with you. If you don’t have an ID card, give the dental office your ID number. Find your ID card and/or ID number in your member account online or in the Ameritas Benefits app.

If you visit an out-of-network dentist, they may ask you to submit a claim for reimbursement. In most instances, you do not need to bring a claim form with you. You will need a statement of services from your dental provider to submit with your claim form.

If you would like your dental provider to consider joining the Ameritas or DentalSelect networks, complete the Nominate a Provider form. We will reach out to their office and invite them to join our network.

Please note: Inviting a dentist to join our network does not guarantee they will become a participating provider.

No. You are welcome to seek treatment from any dentist. If you have the PPO benefit, we suggest using an Ameritas network provider to help maximize your benefits and lower your out-of-pocket expenses.

Yes, however we only honor assignment of benefits to providers in the United States. Since services provided outside the U.S. must be reimbursed directly to the member, foreign-based providers typically require payment in full before services are completed.

For a list of providers that allow you to use your in-network benefits in Mexico, select Find a Contracted Provider in Mexico when viewing the provider directory.

Contact us if you have concerns about the experience you had with a network provider.

Network providers will submit the claim for you. Out-of-network claims can be submitted by you or your dental provider. Contact your provider’s office and ask if they will submit claims for you.

If submitting a claim for an out-of-network visit, you may use any standard claim form, or an Ameritas claim form.

Mail completed claim forms to:
Group Claims
PO Box 82520
Lincoln, NE 68501-2520

If services are performed in the United States, we will assign benefits according to how they are authorized on the claim form. If services are performed outside the United States, benefits will automatically be assigned to the insured member.

If you visit a network provider, benefits are automatically issued directly to the provider based on their contractual agreement, and they submit the claim for you. For out-of-network visits, benefits can be assigned to the insured member or to the provider. If you would like the benefits assigned to you, leave the authorization line blank on the claim form.

Contact us if you are being charged up front for the full amount of your services by a network provider.

No. Although, we do recommend that a pretreatment estimate be submitted for all anticipated work that you consider to be expensive. Pretreatment estimates are the best way for you to determine your out-of-pocket costs based on your plan benefits.

At any time, you have access to an out-of-network dental cost estimator to find average procedure charges in your area. Estimates do not include network discounts or plan benefits.

After your coverage begins, you can view in-network charges in your member account. Select a provider and expand their information card. Then select Dental Cost Estimator and search for a procedure.

You also may ask your dentist’s office to submit a pretreatment estimate so you can see exactly how a proposed service would be covered and avoid any surprises. The pretreatment estimate is based on your plan benefits.

You can file an appeal for Ameritas to review the benefit decision. We will review the submitted claim and your plan benefits. We may ask you or your provider for additional information. Find appeal information on the Forms/Disclosures page.

Your explanation of benefits (EOB) shows what your plan will pay on your claim. It is not a bill. If you have already paid your deductible to the dental office, that will be reflected in their billing statement to you. Contact us if you feel an error has been made on your EOB.

We recommend that claims be submitted as soon as possible, as dental plans have a timely filing clause. Unless otherwise noted in your certificate of coverage, active insured members must submit claims within 90 days of the date of service. Claims submitted after 90 days will be denied due to failure to meet the timely filing requirements.

Group dental plan member: Under many group plans, benefits are released in a maximum of 8 quarterly payments with the first payment being released 3 months after the banding date. Quarterly payments will automatically be released thereafter. However, this may vary by plan.

Individual dental policyholder: Plan payments are pro-rated by monthly periods over the length of the program.

For specifics on your plan’s orthodontic benefits, see your certificate of coverage in your member account.

Child eligibility depends upon age and student status at the time of services. Refer to your certificate of coverage in your member account for details.

Contact us for the most current information.

The American Academy of Pediatric Dentistry (AAPD) recommends that a child go to the dentist by age 1 or within six months of their first tooth coming in.

Wisdom teeth are the upper and lower third molars, located at the very back of the mouth. They are called wisdom teeth because usually they come in between ages 17 and 21 when a person is old enough to have gained some wisdom.

It is not always necessary to have wisdom teeth removed. If they are impacting or crowding the teeth, your dentist will likely recommend removing them.

Many orthodontists say kids should see an orthodontist once their permanent teeth start coming in, around age 7. At this age, issues such as uneven bite and overcrowding will become apparent. Starting the process early doesn’t mean a child will get braces right away.

Your child’s dentist can detect issues and may recommend your child visit an orthodontist for a consultation.