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FREQUENTLY ASKED QUESTION

We accept the following dental insurance PPO plans:

  • Delta Dental PPO
  • Delta Dental Premiere
  • Careington care platinum
  • Metlife
  • Principal
  • Sunlife financial
  • Ameritas
  • Connection Dental
  • Dominion Dental PPO
  • Aetna
  • Cigna DPPO plan (previously called radius)
  • Carefirst blue cross blue shield
  • United health care
  • Guardian
  • DNOA
  • Unicare- 300 net only ( we don`t take unicare 100 or 200)
  • Advantica (formerly Essex Dental Benefits)
  • Aetna Health Management, LLC.(dba Aetna Dental)
  • Altus Dental, Inc.
  • Ameritas Life Insurance Corp (& partners Reliance Standard Life Ins Co., First Reliance Standard Life Ins Co., The Standard Ins Co NY, First Ameritas Life, Security Life insurance Company of America)
  • Best Life and Health Insurance Co. Careington International Corporation & Careington Benefit Solutions (AXA Equitable Life Insurance Company)
  • Dental Network of America (Dearborn National
  • Life Insurance Company & partners BCBS IL,OK, NM, TX, AL)
  • Dental Select (Select Benefits Group)
  • DenteMax (Always Care Benefits, Kaiser Permanente Dental Choice, Beam Dental,
  • TruAssure)
  • Dominion National (formerly Dominion Dental Services) (Capital Blue Cross, Kaiser Permanente)
  • EPIC Life Insurance Company, The Employee Benefit Management ServiCes (EBMS)
  • FCE Benefit Administrators, Inc.
  • First Dental Health, Inc.
  • Foundation for Medical Care (HealthEdge)
  • GEHA Connection Dental Federal
  • GEHA Connection Dental Plus
  • Government Employees Health Association
  • Group Resources Incorporated
  • Guardian Life Insurance Company of America,
  • The HealthCare Solutions Group, Inc.
  • HealthComp, Inc.
  • HealthPlex, Inc.
  • Health Resources, Inc. (Dental Health Options)
  • Kansas City Life Insurance Company
  • Lincoln Financial
  • MetLife Insurance Company
  • Mid American Benefits, Inc.
  • National Rural Electric Cooperative Association
  • Group Benefits Program (NRECA)
  • NovaNet Inc.
    • (Alternative Ins Resources, Argus Dental & Vision Inc, Arm LTD, Benefit and Risk Management Services (BRMS), Boulder Admin Svcs, CareFirst Blue Cross Blue Shield, Chesterfield Resources, CoreSource, Cypress Benefit Admin, DD Services, Inc, Direct Care Admin, Equian LLC, Group Benefit Services, HealthFirst, Med-Pay, Inc., Northern Illinois Health Plan, Nova Healthcare Admin, Preferred Benefit Admin, The Benefit Group Inc, Unified Group Services)
  • Pequot Plus Health Benefit Services
  • Preferred Health Professionals
  • Principal Financial Group
  • Renaissance (Mutual of Omaha)
  • Shasta Administrative Services
  • Sun Life Financial Inc.
  • TriStar Benefit Administrators (formerly Am Administrators)
  • United Healthcare (Dental Benefit Providers,Inc.)
  • UltraBenefits, Inc.
  • United Concordia Inc.
    • (Highmark, Inc., Highmark West Virginia, Highmark Delaware, First Priority Life Insurance Company, HMO of Northeastern Pennsylvania, Inc., d/b/a First Priority Health, Highmark Choice Company, Highmark Select Resources Inc., Highmark Benefits)
  • United Medical Resources, Inc. (UMR)
  • WEB-TPA Employer Services, L.L.C.
  • Aetna: does not access Careington Specialists
  • Key Benefit Administrator
  • American Dental Lifemap
  • American General
  • Lincoln Financial
  • Axa
  • Medico
  • Axis (My Ternian/Ace American Dental
  • Merchants Benefit Administrators
  • Beta Health Association
  • Metlife: does not access Careington Specialists or any Careington providers in the states of NC and SD
  • Blue Cross Blue Shield: Texas, Illinois, New Mexico, Oklahoma, Montana, Michigan, and Kansas City
  • Morgan White
  • Brokers National
  • Mutual of Omaha
  • Century Health Care
  • Nationwide Ins/Coordinated Benefit Plans
  • Colonial Life
  • Nationwide Ins/Health Plan Services Inc
  • DNOA (Dental Network of America)
  • Premier Access
  • Dental Select
  • Maryland Medicaid for kids under 13
  • Printing Specialties
  • Emblem Health/GHI
  • Renaissance Holding
  • EMI Health
  • Revolv Corvesta
  • Employee Painters Trust Health and Welfare
  • Security Life/Meritain
  • Entrust
  • Solstice
  • Global Management
  • Superior Dental
  • Guardian
  • Trans America
  • Harrington/Colonial Life
  • United Health Care/DBP
  • Health Markets
  • Western Teamsters-North West Admin
  • Healthplex
  • Zelis (Formerly Stratose)
  • Humana-FL: does not access Careington Specialists

 

Client Listing for DBP & Stratose

 

DBP/UHC:

  • BEST Health Plans
  • Encore Dental/Stonebridge Life
  • HealthNet – Arizona
  • HealthNet Associates
  • HealthNet of California
  • HealthNet of Oregon
  • Lincoln Financial Group (LFG)
  • Morgan White
  • Peoples Benefit Life Insurance Company
  • Unimerica Dental
  • UnitedHealthcare Dental

 

Zelis (formally Stratose):

  • AmeriBen Solutions
  • CIGNA
  • Citizens Security Life
  • Corporate Benefit Services Inc.
  • Group Administrators
  • Healthscope Dental
  • Humana (excluding AL, AR, CT, GA, FL, & LA) Self Insured Services Co.
  • UHC (AKA Optum Dental) (excluding AR, CT, FL, IA, IL, LA, NC, NE, NY, OR, & WA)

 

  • We do not accept HMOs
  • We do not accept Maryland Medicaid for anyone over 13 years of age. Here are some of the MD Medicaid providers that we do not accept:
    • United Health Care Community Plan – Note” We accept United Healthcare (Dental Benefit Providers, Inc.) 
    • Medstar Family Choice
    • Medicaid through Kaiser Permanente (note: we take Kaiser Permanente Dental Choice)
    • Amerigroup Community Care
    • Jai Medical Systems
    • Maryland Physicians Care
    • Priority Partners

HMO (Health Maintenance Organization) vs. PPO (Preferred Provider Organization) : An Overview

By far the biggest difference between the two types of plans is that HMOs have lower costs and PPOs have increased flexibility

What PPO plans offer

  • Broad range of covered services
  • Typically includes a coinsurance for many services (you pay a percentage of the cost of the service)
  • Often no coinsurance for preventive care
  • Usually there is a maximum amount your plan will pay annually
  • Most plans have deductibles that each member must pay before the plan will begin to pay
  • You can visit any dentist

What HMO plans offer

  • Many covered services, focused on preventive care
  • Typically a member pays a copayment amount per service
  • Most plans have no copayments for preventive care
  • No maximums or deductibles
  • You must visit a provider within the HMO network to receive coverage
  • Your general dentist will refer to you a specialist if necessary
  1. Review your health insurance contract
  2. Look on your benefits card and it should indicate weather it is PPO or HMO
  3. Call your insurance provider
  4.  Google the carrier, plan name and number and it will tell you.

Dental services fall into three main categories:

  • Preventive care, such as annual cleanings, exams, and x-rays.
  • Basic procedures, such as fillings, root canals, and extractions.
  • Major procedures, such as dentures, crowns, bridges, and implants.

There is no one answer to this question since there are a lot of variables at play such as the type of insurance you selected, how much you have already used, etc.; however, the following guidelines can help provide information about dental services covered by insurance:

  1. Most dental plans offer complete coverage for preventive care, although you may have to pay a copayment at the time of service depending on the plan you choose.
  2. Most plans also provide some benefits for basic procedures, such as filling a cavity or removing a badly broken or decayed tooth. You’ll generally pay a deductible, copayment, and/or coinsurance amount for these services.
  3. Some plans also have limited benefits for more complex procedures such as root canals and periodontal treatment for gum disease, for example. You’ll generally pay more out of pocket for these services, however.
  4. Before you buy dental insurance, keep in mind that many dental plans place a limit, or cap, on the amount they will pay for your dental care each year. Once you reach that limit, your plan won’t pay anything, even for procedures that would otherwise be covered.

The answer is “yes” but keep in mind the following.

  • We won’t be able to bill you carrier directly. You will pay Metro Dental for the services, then submit the receipt to your provider to get reimbursed. You will have to make sure that your insurance carrier “out of network” providers.
  • If you do not have insurance at all, you will have to obviously pay out of pocket. We have the following provisions for those without insurance
    • No credit check payment plans. Approximately 12% interest and 10% down payment. 100% approval guarantee!
    • Zero down payment plan. This usually requires good credit and has a lower interest rate
    • Patient membership program. For a very low monthly rate, this allows patients without insurance to reap the benefits of being insured.