Ameritas Copays, Deductibles, and Coinsurance Definitions
If you have determined that you want to enroll in a dental insurance plan to help cover the cost of your regular dental care and any unforeseen emergency treatments, you need to understand what plans are the best options for you. The dental coverage through Ameritas plans is very straightforward, but there are terms that are used across all plans that are important to understand in order to choose the plan that helps you meet your dental and financial goals. Three important concepts, copays, deductibles, and coinsurance, form the foundation of most Ameritas dental insurance plans.
Copays: Your Responsibility
A copay or copayment is a set fee you pay at the time of service. Often, copays vary depending on the type of appointment or treatment. With Ameritas dental insurance, you may not have a copay for preventative visits, such as a routine exam, and you will have a larger copay for a major treatment, such as a root canal. Copays are typically fixed amounts that do not change. For example, you might pay a $20 copay at your appointment, and the insurance plan covers the rest. This predictable cost structure helps you budget for common dental care needs.
Deductibles: The First Step in Coverage
A deductible is the amount of money you must pay out of pocket each year before your insurance benefits begin applying. For instance, if your Ameritas Dental Insurance plan has a $50 annual deductible, you will need to cover the first $50 of eligible dental expenses on your own. Once you have spent this amount, Ameritas starts sharing the costs of covered services. Deductibles are usually reset at the beginning of the year and may vary depending on whether you are on an individual plan or part of a family plan. Many Ameritas plans cover preventive services; those exams and clearings are not subject to the deductible. You are able to receive routine care at little or no cost from the start of the year or the start of your plan.
Coinsurance: Sharing the Remaining Costs
After your deductible has been met, or you have spent the predetermined amount on your own on dental treatments, coinsurance comes into play. Coinsurance is the percentage of the treatment cost that your Ameritas plan pays. For example, if your Ameritas coverage pays 80% of the cost of a filling after your deductible is met, you are responsible for the remaining 20% of the total cost. Coinsurance rates depend on the type of service and vary from one tier of plans to the next. Preventive treatments are frequently covered at 100% without any portion of the bill being paid by you. Basic restorative services may have an 80/20 cost-sharing split, and major procedures may involve a 50/50 arrangement.
How These Pieces Work Together
Now, let’s understand how all three of these terms work together in a real-world scenario: You are at the dentist for a filling. You first pay a small copay at the time of your appointment. If you have not yet met your deductible for the year, you will pay the portion of the treatment cost until that deductible is satisfied. Once the deductible is met, coinsurance applies, and the remaining bill is shared between you and Ameritas.
If you have more questions about Ameritas Insurance or how it could work as a part of your treatment plan to achieve better dental health, make an appointment with the dentist to see if Ameritas Insurance is the best option for you.
Learn more about what to expect during your visit and payment options.