Is Ameritas Dental Insurance the Right Choice for Your Smile?

Finding the right dental insurance can sometimes feel like a journey through a maze of confusing terms and fine print. You want coverage that protects your smile without breaking the bank. If you have been researching your options, you have likely come across the name “Ameritas.” It is a well-known player in the dental insurance world, but is it the right fit for you and your family?

This comprehensive guide is designed to give you a realistic, clear, and honest look at Ameritas dental insurance. Forget the confusing jargon. We are going to break down everything you need to know—from the different types of plans available to what happens when you actually sit in the dentist’s chair. Whether you are shopping for insurance through your employer or looking for an individual plan, consider this your friendly roadmap to understanding Ameritas.

Understanding the Basics: What is Ameritas?

Before diving into the specifics of plans and premiums, it helps to know a little about the company behind the insurance. Ameritas is not a fly-by-night startup; it is a company with deep roots in the financial and insurance sectors.

Ameritas Life Insurance Corp. was founded over 135 years ago. This long history suggests a level of stability and experience that is important when you are choosing a company to handle your health and financial well-being. They specialize in employee benefits, which is why many people first encounter Ameritas through their job. However, they are also a significant provider for individuals and families looking for coverage on their own.

A key part of their identity is their mutual holding company structure. In simple terms, this means the company is owned by its policyholders, not by outside shareholders. This structure can sometimes influence a company to focus more on long-term value for its members rather than short-term profits for investors.

Important Note: While a company’s history and structure are good to know, they don’t automatically guarantee that a specific plan is perfect for you. The real proof is in the details of the coverage.

The Core of Coverage: How Ameritas Dental Plans Are Structured

Most traditional dental insurance plans, including those from Ameritas, follow a similar structure based on the type of dental care you need. Understanding these three categories is the first step to understanding your benefits.

Preventive Care: The Foundation of Good Oral Health

This is the most important category. Preventive care includes routine visits that help you maintain good oral health and catch small issues before they become big, expensive problems.

• What’s typically covered: Routine oral exams (usually two per year), professional cleanings (usually two per year), and bitewing X-rays.

• Ameritas’s approach: Ameritas strongly encourages preventive care. Most of their plans cover 100% of the cost for these services. You generally pay nothing out-of-pocket for these visits, making it easy to stay on top of your dental health.

Basic Restorative Care: Fixing Common Problems

This category covers the most common procedures you might need to fix damage or decay.

• What’s typically covered: Fillings, simple extractions, and sometimes periodontal (gum) treatment.

• Ameritas’s approach: For basic care, plans usually cover a percentage of the cost, and you are responsible for the rest. With Ameritas, you will often see coinsurance of around 20% to 50%. For example, if you need a filling and the plan covers basic care at 80%, Ameritas pays 80% of the allowed amount, and you pay the remaining 20%.

Major Restorative Care: More Complex Procedures

This category includes the more significant and costly dental work.

• What’s typically covered: Crowns, bridges, dentures, inlays, onlays, and sometimes oral surgery.

• Ameritas’s approach: Major care has the lowest level of coverage. You might see coinsurance of 50% for these procedures. This means you and the insurance company share the cost equally. This is why having a plan that also includes orthodontic coverage can be valuable if you or your child needs braces.

This three-tiered system is the standard for the industry, and Ameritas follows it closely, making their plans easy to understand and compare.

A Closer Look at Ameritas Plan Options

One of the strengths of Ameritas is the variety they offer. They understand that a young single professional has different dental needs and a different budget than a family with teenagers. Here is a breakdown of the main types of dental plans you will find from Ameritas.

Ameritas PPO Plans (DentalPlus)

The Preferred Provider Organization (PPO) plan is the most popular and common type of dental insurance. It offers a great balance of flexibility and cost savings.

• How it works: Ameritas contracts with a network of dentists who agree to provide services at a reduced rate. When you visit a dentist in this network, you benefit from those lower, pre-negotiated rates. You also usually receive a higher level of coverage.

• Pros:

  • Freedom of Choice: You can see any dentist, but you save the most by staying in-network.

  • Predictable Costs: The negotiated rates help keep your costs down and make them more predictable.

  • Large Network: Ameritas has a sizeable national network, making it likely you can find a quality in-network provider near you.

• Cons:

  • Out-of-Network Costs: If you go to a dentist outside the network, you will likely pay more, and the process for filing claims may be less convenient (you might have to pay upfront and submit the paperwork yourself).

Ameritas Managed Care Plans (DentalHMO)

Also sometimes referred to as a Dental Health Maintenance Organization (DHMO) or a prepaid plan, this is a different model from a PPO.

• How it works: You choose a primary care dentist from a specific network. There are no annual deductibles or maximums, and you pay a set copayment for each type of service (e.g., a $10 copay for a cleaning, a $50 copay for a filling).

• Pros:

  • Very Low Premiums: These are typically the most budget-friendly plans in terms of monthly cost.

  • No Deductibles: You don’t have to meet a deductible before coverage kicks in.

  • Predictable Copays: You know exactly what you will pay for a procedure before you go.

• Cons:

  • Limited Choice: You must receive care from your selected in-network dentist. Going out-of-network usually means you pay 100% of the cost.

  • Less Flexibility: It can be harder to see a specialist, and you may need a referral from your primary dentist.

Ameritas Indemnity Plans (Traditional)

This is the most traditional, “old-school” type of dental insurance. It offers maximum freedom but less predictable costs.

• How it works: You can see any dentist you choose. You pay for the services upfront, and then you submit a claim to Ameritas, which reimburses you for a set percentage of the cost based on a fee schedule.

• Pros:

  • Ultimate Freedom: You are not restricted by any network. You can see the dentist you trust most, regardless of whether they are affiliated with Ameritas.

• Cons:

  • More Paperwork: You are responsible for filing your own claims.

  • Less Predictable Costs: You may not know exactly how much you will be reimbursed until after the claim is processed. You are also responsible for the difference between the dentist’s fee and what Ameritas considers “reasonable and customary.”

Stand-Alone vs. Employer-Sponsored Plans

It is also important to distinguish between how you get your Ameritas coverage.

• Employer-Sponsored: This is the most common way to get dental insurance. Your employer has negotiated a group plan, and they often pay a portion of your premium. This is almost always the most cost-effective way to get comprehensive coverage.

• Stand-Alone (Individual & Family): If you are self-employed, retired, or your job doesn’t offer benefits, you can purchase an Ameritas plan directly. These plans are tailored for individuals and families and provide a crucial safety net. While you pay the full premium yourself, having coverage is still far more affordable than paying for major dental work out-of-pocket.

Comparing Ameritas Dental Plans

To make the differences clearer, here is a simplified comparison of the three main plan types you might encounter from Ameritas.

Diving Deep into the Numbers: Costs and Coverage Details

Now, let’s get into the nitty-gritty. Insurance is full of terms that can be confusing. Here is what you need to know about the specific costs associated with an Ameritas dental plan.

Understanding Deductibles, Coinsurance, and Annual Maximums

These three terms form the financial foundation of your PPO or Indemnity plan.

• Deductible: This is the amount you must pay out-of-pocket for covered services before your insurance starts to pay. For example, if your plan has a $50 individual deductible, you will pay the first $50 of your basic or major care costs for the year. Preventive care is almost always exempt from the deductible, meaning it is covered from day one.

• Coinsurance: This is your share of the costs after you’ve met your deductible. It is expressed as a percentage. As we saw earlier, a plan might have 80/20 coinsurance for basic care. After your deductible, Ameritas pays 80%, and you pay 20%.

• Annual Maximum: This is the total dollar amount your Ameritas plan will pay toward the cost of your covered dental care within a one-year benefit period (often a calendar year). For many plans, this can be around $1,500. If your dental costs exceed this amount, you are responsible for the rest. Some Ameritas plans offer higher annual maximums, especially those geared towards families or comprehensive coverage.

What About Orthodontic Coverage?

This is a major question for families. Does Ameritas cover braces and other orthodontic treatment?
The answer is: it depends on the plan. Many standard Ameritas dental plans do not include orthodontic benefits for adults or children. However, orthodontic coverage is often available as an optional rider or as part of a more comprehensive plan tier.

If orthodontics is a priority for you, you need to be very careful when selecting a plan. Look for plans explicitly labeled as covering orthodontia. When they do, it often works a little differently. There may be a separate, lifetime orthodontic maximum (e.g., $1,500) rather than an annual one, and the coverage might be structured differently.

Understanding Waiting Periods

A waiting period is the time you must be enrolled in a plan before it will cover certain procedures. This is a standard feature in many individual dental insurance plans to prevent people from signing up only when they need expensive work.

• Ameritas and Waiting Periods: Ameritas plans for individuals and families often have waiting periods for major and sometimes basic services. For example, you might have to wait 6 months for basic restorative care and 12 months for major care.

• How to Navigate This: If you need work done immediately, a plan with waiting periods won’t help you right away. Some plans may waive waiting periods if you had prior credible dental coverage. Always ask about this. If you are getting insurance through your employer, waiting periods are often reduced or eliminated entirely.

Important Note: Always read the “Exclusions and Limitations” section of your plan’s details. This is where you will find specific services that are not covered, such as cosmetic procedures like teeth whitening or veneers, or limitations on how often you can get certain treatments (e.g., one crown every five years on the same tooth).

The Network Advantage: Finding an Ameritas Dentist

One of the most practical considerations when choosing any insurance is the network of available providers. What good is great coverage if you can’t use it with a dentist you trust?

Ameritas has a robust national network. They have partnered with a significant number of dentists across the country, making it likely you can find a participating provider nearby. They also participate in large, reputable dental networks, which expands your options even further.

How to Find a Dentist:
The easiest way is to use the provider search tool on the Ameritas website. You can search by address, zip code, or even by a specific dentist’s name. The tool will show you which dentists are currently accepting new patients and what their specialties are.

The In-Network Advantage:
When you choose an in-network dentist with an Ameritas PPO plan, the benefits go beyond just a lower rate.

1. No Balance Billing: The dentist has agreed to accept the Ameritas negotiated fee as payment in full. You will not be billed for the difference between their normal fee and the allowed amount.

2. Convenience: The dentist’s office will typically file your claims directly with Ameritas. You won’t have to worry about paperwork.

3. Guaranteed Savings: You are automatically benefiting from the discounted rates, even if you haven’t met your deductible yet.

The Enrollment Process: How to Get Ameritas Insurance

Getting covered by Ameritas is a straightforward process, whether through your job or on your own.

For Employer-Sponsored Plans:
This is usually the easiest route. During your company’s open enrollment period, you simply select the dental plan offered. Payroll deductions are set up, and your coverage begins on the effective date. You can also enroll when you are first hired or after a qualifying life event (like marriage or having a baby).

For Individual and Family Plans:
You can apply for Ameritas dental insurance directly through their website or by speaking with a licensed insurance agent. The process is entirely online and typically takes just a few minutes.

1. Get a Quote: You will enter your zip code, date of birth, and other basic information.

2. Compare Plans: You will be presented with the different plan options available in your state (PPO, DHMO, etc.). You can compare the premiums, deductibles, and coverage details side-by-side.

3. Apply: Once you have chosen a plan, you will complete a short application. Underwriting for dental insurance is typically very simple. Unlike health insurance, you usually won’t need a physical exam. However, pre-existing conditions may be subject to waiting periods.

4. Pay Your First Premium: You will pay your first month’s premium to activate your coverage.

5. Receive Your Materials: You will get a welcome packet with your member ID card and plan documents. You can often access your digital ID card immediately through the Ameritas member portal.

Ameritas Customer Service and Digital Tools

In today’s world, the quality of a company’s digital tools and customer service is just as important as the coverage itself. Ameritas has invested in making the member experience smooth and accessible.

The Ameritas Member Portal:
Once you are enrolled, you will have access to a secure online portal. This is your central hub for managing your dental benefits. You can:

• View your digital ID card.

• Check the status of claims.

• See your explanation of benefits (EOB).

• Review your deductible and annual maximum status.

• Find an in-network dentist.

• Update your personal information.

Customer Service:
Ameritas has a team of customer service representatives available by phone to answer your questions. As with any large company, customer service experiences can vary. However, Ameritas generally receives positive marks for having helpful and knowledgeable phone support. They also maintain an active presence on social media, providing another avenue for customer inquiries.

The Member Experience: What It’s Like to Use Ameritas

Let’s walk through a typical scenario of using your Ameritas dental insurance. Imagine you have an Ameritas PPO plan and you need to go for your routine checkup.

1. Scheduling: You find an in-network dentist using the Ameritas online tool and book your appointment. You provide your insurance information when you schedule.

2. The Appointment: At the dentist’s office, you show your Ameritas ID card (or they have it on file). You get your routine cleaning and exam. The dentist finds a small cavity that needs a filling.

3. Checkout: After the appointment, you go to the front desk. Because you saw an in-network dentist, the office handles all the claim filing with Ameritas. For your preventive care (exam and cleaning), the office confirms that Ameritas covers it at 100%, so you owe nothing for that part of the visit.

4. The Follow-Up: You schedule a separate appointment to get the filling. Before you leave, the front desk may give you an estimate of your out-of-pocket cost based on your plan’s coverage for basic care. They will file a pre-determination of benefits with Ameritas to confirm the exact amount. This is a great tool to avoid surprises.

5. The Filling Appointment: You return for the filling. You pay your estimated portion of the bill (the 20% coinsurance) at the time of service. The dentist’s office submits the claim for the remaining 80%.

6. Afterward: You receive an Explanation of Benefits (EOB) from Ameritas in the mail or through the member portal. It explains what was paid to the dentist, what you were responsible for, and how this affects your deductible and annual maximum.

This seamless process is the ideal member experience, made possible by choosing an in-network provider and understanding your plan’s coverage tiers.

The Pros and Cons: An Honest Assessment of Ameritas

No insurance company is perfect for everyone. Let’s weigh the realistic pros and cons of choosing Ameritas for your dental coverage.

The Pros:

• Financial Strength and Stability: With over 135 years in business, Ameritas is a reliable and established company. This gives policyholders peace of mind.

• Variety of Plans: They offer a comprehensive range of plan types (PPO, DHMO, Indemnity) to fit different budgets and needs. This flexibility is a major advantage.

• Large Provider Network: Their extensive national network means a good chance of finding a convenient, in-network dentist.

• Strong Focus on Preventive Care: Like all good dental insurers, they fully cover preventive services, encouraging members to maintain their oral health.

• User-Friendly Digital Tools: The member portal and online resources make managing your benefits simple and convenient.

The Cons:

• Waiting Periods on Individual Plans: For those buying insurance on their own, waiting periods for major and basic care can be a hurdle if you need immediate treatment.

• Orthodontia is Not Standard: Coverage for braces and other orthodontic work is often an add-on, not included in base plans. You must be diligent in selecting a plan that meets this need.

• Annual Maximums: Like many dental plans, the annual maximum can feel low, especially if you require extensive, costly dental work in a single year.

• Customer Service Variability: While generally good, some customer reviews mention occasional challenges with phone wait times or claim processing.

Ameritas vs. The Competition: A Quick Look

To put Ameritas in perspective, it’s helpful to see how it stacks up against other major dental insurance providers. Remember, the “best” company often depends on your specific situation.

Friendly Reminder: The best way to compare is to get quotes from each company for the exact type of coverage you need in your specific area. Don’t just rely on brand reputation.

Frequently Asked Questions (FAQ)

Q: Does Ameritas cover dental implants?
A: Coverage for dental implants varies by plan. They are often considered a major restorative procedure, so a plan with major care coverage might cover a portion of the cost, typically around 50% after your deductible. However, some plans may have specific exclusions or limits for implants. Always check the plan details or call Ameritas to confirm.

Q: Can I get Ameritas dental insurance if I am retired?
A: Yes, absolutely. Ameritas offers individual and family plans that are perfect for retirees who no longer have employer-sponsored coverage. It’s a great way to maintain your oral health in retirement.

Q: Is there a waiting period for preventive care?
A: Typically, no. Preventive care like cleanings and exams is usually covered from your effective date with no waiting period. This allows you to start using your benefits for routine maintenance right away.

Q: What is a pre-determination of benefits?
A: This is a request your dentist can send to Ameritas before you undergo a major procedure (like a crown). Ameritas will review the planned treatment and your benefits, then send you and your dentist an estimate of how much they will pay and how much you will owe. It is a highly recommended step to avoid unexpected bills.

Q: How do I cancel my Ameritas dental insurance?
A: If you have an individual plan, you can typically cancel your policy by calling Ameritas customer service. If you have an employer-sponsored plan, you must cancel through your employer’s human resources department.

Making Your Final Decision

So, after all this information, is Ameritas dental insurance the right choice for you? The answer lies in your personal priorities.

Choose Ameritas if:

• You value a company with a long history and financial stability.

• You want a wide variety of plan options to choose from, especially if you are buying coverage for yourself.

• Finding a large, national network of dentists is important to you.

• You are comfortable with the standard industry structure of deductibles, coinsurance, and annual maximums.

You might want to explore other options if:

• You need a plan with a very high annual maximum (above $2,000+).

• Orthodontic coverage is your absolute top priority and you want it included in the base plan without an add-on.

• You have had a negative personal experience with Ameritas customer service in the past.

Ultimately, the best way to decide is to get a quote. Visit the Ameritas website, enter your information, and look at the specific plans available in your state. Read the summary of benefits carefully. Compare them not just on price, but on the details of coverage that matter most to you. Are you someone who just needs routine cleanings? A basic, low-premium plan might be perfect. Are you planning on significant dental work? A more comprehensive PPO plan with a higher annual maximum is the wiser investment.

Your smile is an important part of your overall health. Taking the time to find the right dental insurance is a step towards protecting it for years to come. Ameritas is a solid, reputable contender in the dental insurance space, and for many people, their plans provide the perfect balance of cost, coverage, and peace of mind.

Conclusion

Ameritas offers a robust and reliable selection of dental insurance plans suitable for individuals, families, and employees. By understanding the differences between their PPO, DHMO, and Indemnity options, you can select a plan that aligns with both your budget and your oral health needs. With a strong focus on preventive care and a vast provider network, Ameritas stands as a trustworthy partner in maintaining a healthy smile for the long term.

Additional Resource

For the most current information, to get a personalized quote, or to find an in-network dentist near you, please visit the official Ameritas website: [www.ameritas.com] (Note: As per the instruction to not disseminate false information, this is a placeholder for the official URL. Please ensure you navigate to their official dental insurance page.)