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$34.29 /mo.

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Hollywood Smile Premier Plus 2000

Plan Type PPO

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$34.29 /mo.

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Plan Highlights

As long as you meet the plan's general eligibility requirements and pay the applicable premium, your acceptance is automatic
You can also include all eligible children under your guardianship
The Hollywood Smile Premier Plus 2000 Plan is a PPO plan
The Hollywood Smile Premier Plus 2000 Plan helps pay the cost of most dental care services, including exams, cleanings, fillings, extractions, crowns, bridges and dentures
Money-saving Preventive Plus benefit offered with this plan - Type 1 Preventive procedures are not deducted from the plan's annual maximum benefit. This saves all of the annual benefit to help pay for more expensive Type 2 (Basic) and 3 (Major) procedures.
Apply online for your convenience and have the cost of insurance automatically deducted from your checking or savings account. That way you will have no extra checks to write and no new due dates to remember

Common Procedures

Details

Fee Schedule: N/A | Dentist Search

Exams: Routine periodic examinations - 2 in a benefit year
100% after deductible
Preventive – No waiting period

Cleanings: Teeth Cleanings – 3 in a benefit year
100% after deductible
Preventive – No waiting period

X-Rays: Radiography: X-rays
1st year – 50% after deductible
2nd year and after – 80% after deductible
Basic – No waiting period

Fillings: Restorative Amalgam Fillings. Resin–based composite (white fillings) anterior only
1st year – 50% after deductible
2nd year and after – 80% after deductible
Basic – No waiting period

Extractions: Simple Extractions and Oral Surgery
50% after deductible
Major – 12 months waiting period

Crowns: 50% after deductible
Major – 12 months waiting period

Root Canals: Endodontics: Pulpal therapy and root canals
50% after deductible
Major – 12 months waiting period

Dentures: 50% after deductible
Major – 12 months waiting period

Deep Cleanings: Treatment of diseases of the gums
50% after deductible
Major – 12 months waiting period

Implants: Not Covered Service

Braces / Orthodontia: Not Covered Service

Teeth Whitening: Not Covered Service

Additional Network Information:

The Ameritas Dental Network is one of the nation’s largest. Network providers have agreed to charge 25-50% less than their regular rates which can lower your out-of-pocket costs.

The Maximum Allowable Charge (MAC) claim allowance is the maximum amount a network provider may charge. If you select a network provider, you may have lower out-of-pocket costs. If you visit an out-of-network dentist, the claim allowance is considered at the Maximum Allowable Benefit (MAB), which is equal to the lowest contracted fee in your ZIP Code. Any difference between the plan allowance and the dentist’s charge will be an out-of-pocket expense for you.

You can visit any dentist, in- or out-of-network. And family members do not need to visit the same provider.

Find a dental provider near you.

PPO Plans not available in all states.

Exclusions and Limitations
Plan Brochure: N/A

FAQ

Can I change my dentist once I am in the plan?

Yes, you may change your dentist at any time.

What is a pre-existing condition versus work-in-progress? Is it covered?

What provider options do I have?

When can I start using my Plan?

When will I receive my new member kit and what will it include?

Who can enroll in this plan?

Ameritas Life Insurance Corp. of New York
1350 Broadway Suite 1710
New York, NY 10018

Disclaimers & Disclosures

Ameritas Life Insurance Corp. of New York:

Underwritten by Ameritas Life Insurance Corp. of New York | 1350 Broadway Suite 1710 New York, NY 10018

This is not a certificate of insurance or guarantee of coverage. Plan designs may not be available in all areas and are subject to individual state regulations. This information is provided by Ameritas Life Insurance Corp. of New York (Ameritas of New York). Dental and vision products (9000 NY Rev. 03-15 for Group and 9000 NY Rev. 03-18 for Individual) are issued by Ameritas of New York. Ameritas, the bison design and “fulfilling life” are service marks or registered service marks of Ameritas Life, affiliate Ameritas Holding Company or Ameritas Mutual Holding Company. © 2024 Ameritas Mutual Holding Company.

This website provides a very brief description of some of the important features of this plan. It is not the insurance contract, nor does it represent the insurance contract. A full description of benefits, exclusions and limitations is contained in the Schedule of Benefits and your policy.

Rates shown are based upon the information you provided, and are subject to change based on the dental and/or vision plan's underwriting practices and your selection of available optional benefits, if any. Final rates and effective dates are subject to underwriting and are always determined by the dental insurance and/or vision insurance company. To be considered for reimbursement, expenses must qualify as covered expenses.

This site was designed to provide you with a general description of the plans you requested. Keep in mind that it does not include all the benefits and limitations outlined in the policies -- it is the insurance contract, not the general descriptions on this website, which forms the contract between you and the insurance company.

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