Click here for the NationalCare Dental Brochure. They have several plan offerings with benefits of up to $5000 per year, offer take-over benefits, and will credit prior coverage. These plans are backed by Nationwide Insurance, a respected name in our industry. We are excited about these dental plans and would love to chat with you about them. If you’d like to enroll or have other questions click below to contact your agent of choice via email, or give us a call.
This plan allows you to see any dentist of your choice and receive benefits. There is a PPO network, however, and your benefits will always be better if you stay in-network. To check and see if your dentist accepts this plan please click here. If your dentist is not in the network then this plan will pay the maximum allowable charge, or “MAC”. An example of seeing out-of-network providers is shown in the table below.
| In-Network | Out-of-Network | |
|---|---|---|
| Procedure | Filling | Filling |
| Provider Billed Amount | $100 | $130 |
| MAC | $100 | $100 |
| Basic Services % | 80% | 80% |
| Insurance Pays | $80 (80% of MAC) | $80 (80% of MAC) |
| Member Pays | $20 | $50 |
- In-network providers are dental providers that have chosen to contract with Maximum Care PPO. The providers agree to accept a PPO contracted fee schedule as the maximum allowable charge (MAC), and agree to write off the difference between their standard bill rates and the MAC. The dental provider cannot charge the member any additional out-of-pocket expenses for services covered under the dental plan. The member will be responsible for any remaining deductible, co-pay, or non-covered services.
- Out-of-network providers are dental providers that are not contracted with Maximum Care PPO. These dental providers will bill the member at their own bill rates, which may be higher than the MAC. The insurance company will pay the dental provider based on the MAC. The patient will be responsible for paying the dental provider for the difference between the dental provider bill rates and the MAC, in addition to any remaining deductible, co-pay, or non-covered services.