Quality Affordable Dental Insurance
Group association dental insurance under the DentaCert Dental Insurance Plan is underwritten by Madison National Life
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DentaCert Insured Dental Plan About the Insurance Company Group association dental insurance is underwritten by Madison National Life Insurance Company, Inc., a member of The IHC Group. Madison National is rated A- (Excellent) for financial strength by A.M. Best Company, Inc., a widely recognized rating agency that rates insurance companies on their relative financial strength and ability to meet their obligations. (An A++ rating from A.M. Best is its highest rating.) The IHC Group has been providing life, health and stop-loss insurance solutions for over 30 years.
About Membership As an advantage of membership, NationalWay provides its members access to specialized programs like the DentaCert Insured Dental Plan. Membership is available to individuals and their families. NationalWay offers two dental insurance plans to its members, each designed to provide maximum dental coverage at the lowest possible monthly cost.
About The Dental Plans Highlights DentaCert Insured Dental Plans are dental plans designed exclusively for NationalWay members. There are two dental insurance plan options to choose from allowing members to select the plan that best suits their needs and budget. Although each plan provides the maximum benefits, a covered person can save money when services are received at any one of thousands of dental network providers available nationwide. When a network dentist is used, all dental services will be reduced which can reduce the member’s out-of-pocket expenses.
About The Network
Members under the DentaCert Insured Dental Plans have access to DenteMax, a nationwide Network of dental providers. DenteMax is one of the largest provider networks in America. When you need to access a dental provider in your area you can simply go to their website at www.dentemax.com. Providers within the DenteMax network not only offer the highest quality dental services but also have contracted with the network to provide you their services at reduced prices.
NationalWay HealthCare Association is a not-for-profit member association with thousands of members throughout the United States. The association’s purpose is to educate and inform its members with the latest and most up-to-date changes and information concerning the health and wellness of American workers and their families Madison National Life Insurance Company, Inc. Group association dental insurance is underwritten by Madison National Life Insurance Company, Inc., a member of The IHC Group. Madison National is rated A- (Excellent) for financial strength by A.M. Best Company, Inc., a widely recognized rating agency that rates insurance companies on their relative financial strength and ability to meet their obligations. (An A++ rating from A.M. Best is its highest rating.) There is no ownership or affiliation between Madison National, Dentemax or NationalWay Assocation.
Smile Protection Value Plan (Plan A)
The Value Plan
Our most affordable Dental Plan The Value Plan pays preventive and diagnostic benefits once a year at no cost to the insured. The member can choose a contracted provider from one of the largest dental networks in the United States. Dental services for basic and major procedures will be reduced and repriced based upon the contracted discount network schedule. These network savings can vary from 15% to 50%. There are no waiting periods and no limits on the number of times the network benefits can be used.
Features Our Most Affordable Dental Plan Guaranteed Issue No Waiting Period
Preventive Paid 100% of Covered Charges
Diagnostic Paid 100% of Covered Charges
Preventive Care - No waiting Period Routine Oral Exam - 1 per calendar year Comprehensive Oral Exam
100% of covered charges
- 1 per calendar year
Consultation - other than treating doctor, 1 per calendar year
Problem Focused Exams - 1 per calendar year, per member
Prophylaxis - Cleaning & scaling of teeth, 1 per calendar year
Fluoride - 1 per calendar year, for dependent children under 16
Diagnostic Care - No waiting Period Intra-Oral Occlusal Film Bitewing X-Rays
100% of covered charges
1 per calendar year, per member, up to set of 4 Full Mouth X-Rays - 1 per 36 consecutive months
Basic and Major and All Other Dental Procedures There are no insurance benefits for basic and major procedures, including orthodontics. However, treatment for these procedures received by a Dentemax dental provider will still receive a contracted discount of 15-50%. (Contracted Providers Not available in all states) 3
Select Plan (Plan D)
The Select Plan (Plan D)
our very best dental plan with the most comprehensive benefits
The Select Plan provides preventive care and diagnostic care services with a $10 per office visit co-pay. Also included is one cleaning per six month period covered at 100% of covered charges. Benefits for other covered procedures are paid based on the lesser of the dentist’s actual charge or the fee schedule amounts. The maximum benefit for all covered procedures is $2,000 per covered person per calendar year.. Members have access to dental provider discounts through a network of contracted providers. While a covered person has the flexibility to choose any provider, the discounts available through a dental provider within the network will help to lower his/her out-of-pocket costs.
Plan pays the lesser of the dentist’s actual charges or fee schedule amounts.
per year per person
Prophylaxis (cleaning and
scaling) 1 per 6 month period covered at 100%
Individual - $100 per person per calendar year Family Limit - NONE
$10 Co-Pay Office Visit for preventive care and diagnostic care services
No Waiting Period Initial Oral Exam, Periodic Oral Exam (1 per calendar year), Prophylaxis (cleaning and scaling of teeth (1 per six month period) 100% covered, Sealants Up to age 13 (1 treatment per tooth during a 36 consecutive month period), Topical Fluoride Up to age 19 (1 per calendar year), Emergency Palliative Treatment
Affordable Premiums $2,000 Maximum Benefit Per Calendar Year Per Person
$10 Co-Pay per Office Visit for preventive care and diagnostic care services
Bitewing X-Rays (1 per calendar year). Full mouth x-rays (1 per 36 consecutive month period)
Initial Oral Exam, and one Periodic Oral Exam per calendar Basic Care
No Waiting Period
No Waiting Period Simple Extractions, Fillings, Denture Repairs
No Health Questions
Periodontics, Endodontics, Oral Surgery, Crowns, Dentures, Bridges, and Implants, have a 6 month waiting period
Orthodontic Benefit for dependent children under age 19 (after a 12 month waiting period)
6 month waiting period
12 Month Waiting Period Covered at up 50% up to $500 calendar year maximum. $1,000 Life time maximum.
*Orthodontic treatment for dependent children under age 19
Contracted Providers Not available in all states
Exclusions The following is a partial listing of exclusions from coverage. Please consult the Certificate of Insurance for a complete description of charges, services and supplies excluded from coverage. Benefits will not be paid for dental expenses arising from or in connection with: - Treatment, services or supplies which: - Are not medically necessary - Are not prescribed by a dentist - Are determined to be experimental/ investigational in nature by us -– Implants of any type and all related procedures: – Periodontal splinting – Porcelain on crowns, or pontics posterior to the 2nd bicuspid– Replacement of partial or full dentures, fixed or removable bridge work, crowns, gold restorations and jackets more often than once in any five-year period – Lost, stolen or missing dentures or bridges for duplicates – Charges payable under any medical insurance – Charges made by any government entity, unless the covered person is required to pay, or by any public entity from which coverage could have been obtained by application or enrollment even if application or enrollment was not actually made – Use of materials, other than fluorides or sealants, to prevent tooth decay – Bite registrations – Bacteriologic cultures – Therapeutic injections administered by a dentist – Replacement of 3rd molars – Composites on teeth posterior to the second bicuspid– Crowns, inlays and onlays used to restore teeth with microfractures or fracture lines, undermined cusps, or existing large restorations without overt pathology or Temporomandibular joint syndrome.
Group Policy form MNL-ADEN-POL 0905 is issued to NationalWay Healthcare Association. Coverage not available in all jurisdictions. This brochure is a brief description of coverage only and does not constitute a policy or coverage. Please refer to the certificate of insurance for a complete description of benefits, conditions and limitations.
Plan Options & Pricing
Choose The Dental Plan That Best Meets Your Needs Plan
$ .01 $ .78 $ .55 per month per month per month
*Select Plan (Plan D)
$ .40 per month
$ .96 per month
$ .10 $ .98 $ .38 per month per month per month
*There is a One Time $10 Enrollment fee per Membership. The membership dues consists of association benefits, including but not limited to lifestyle services and discount services; insurance coverages; and marketing and administration of association membership.
Diagnostic, Imaging & Lab Included
THIS IS A NON-INSURANCE BENEFIT Network Provided by: One Call Medical
What Exactly Does This Mean To You? You or your family will not have to pay full price for included services.
How Big Are Your Savings? The savings are 40% to 70% off the usual price. (See a small sample of these prices in the charts below.) How Big Is Your Network? Your network of testing facilities is nationwide and includes all the well known, accredited companies including LabCorp. When Can You Use This Program? Any time your doctor orders a test, you simply call your personal scheduling department and they will advise you of the most convenient location and ensure that you only pay the reduced Group Rate. Sample of Savings - Lab work (1700 Tests included)
Test Cholesterol Thyroid Test Cancer Antigen test Prostate Test (PSA) Test MRI CT Scan
Normal Price $34.00 $108.00 $122.00 $114.00 Normal Price $1,536.00 $960.00
Member Pays $17.25 $37.00 $65.00 $40.25
Member Pays $695.00 $450.00
Not available in Massachusetts, New York, New Jersey, or Rhode Island
Prescription Card THESE ARE NON-INSURANCE BENEFITS
Prescription Card (Discount)
You will receive as much as 55-65% off AWP discount for your generics, and 15% off AWP for name brand prescription drugs at your local pharmacy. The Prescription Plan is accepted by most local and chain pharmacies throughout the U.S. Members pay wholesale cost plus a small dispensing fee. 90-day supply mail order plans are available.
Mail order pharmacy
The mail order program allows members to obtain a 90-day supply of medication that can be mailed directly to the subscribers home. The program provides convenience and low cost options on maintenance medications.
WorldDoc Online Health Decision Support Information
WorldDoc offers on line health decision support services that empower people to make better health care choices. For example, WorldDoc helps people decide what they may have and what they should do for medical problems like cough, red eye, high blood pressure, asthma, or knee pain. No other company offers comprehensive health decision support that answers people’s questions. A team of board certified doctors in 20 specialties created WorldDoc. The medical information contained in WorldDoc covers over 90% of common medical conditions. Only WorldDoc offers comprehensive health decision support services. WorldDoc is an interactive application, not static content and uses technology to service a large number of subscribers at low cost.
Non Insurance Benefit
Questions & Answers Q: How is the DentaCert Member Dental Plan different than other plans? A: T he DentaCert Plan is an association endorsed group
insurance plan available to NationalWay members. The plan is designed to keep dental insurance premiums affordable and competitive. The member has the freedom to choose among two plan designs and select the best plan for his/ her budget..
Q:What is the importance of the Association? A: T he DentaCert plan is designed exclusively for the members
of NationalWay. The Association has thousands of members throughout the United States enabling the Association to use its massive buying power to offer its members economical, guaranteed issue, member dental benefits that cannot normally be purchased as an individual.
Q: Can I use my own dentist? A : Yes, the DentaCert Dental Plan provides a benefit fee schedule
Q: Why is “Guaranteed Issue” important?
for each covered dental procedure allowing the freedom to choose any dentist or specialist. If one of the contracted Network providers is used, your out-of-pocket expense will be reduced.
A: A cceptance in the DentaCert Dental Plan is guaranteed
Q: Are there waiting periods?
for all members of NationalWay. When buying a traditional dental plan, many individuals are faced with extended benefit waiting periods. However, with the DentaCert Dental Plan, no previous dental history questions are ever asked, your individual premiums are never rated up, and there are few to no waiting periods for most covered procedures.
Q: Does the employer have to pay all or part of the cost of the dental plan? A: No, the DentaCert Member Dental Plan does not require employers to pay any part of the employees dental plan. It can be offered to employees on a strictly voluntary basis through payroll deduction, or the employer can choose to select any financial contribution that he/she feels they can afford.
Q: What are the participation requirements? A: W ith the DentaCert Plan, employers have no “participation requirements” compelling a percentage of company employees to enroll in the dental plan. Even just one employee can choose the dental plan option allowing the employer to offer the dental program on a voluntary basis through payroll deduction or pay all or partial cost of the program on behalf of the employees.
Q: How Can I find a network dentist?
A: T here are no waiting periods for any preventive care
procedures (oral exams, sealants, and fluoride ), diagnostic care procedures (bite wing x-rays) or covered basic care dental procedures (extractions, fillings, repairs). These benefits go into effect immediately following the effective date of coverage under the dental policy. There is only a six (6) month waiting period for major care procedures and twelve (12) month waiting period for orthodontics when covered for dependent children..
Q: Who is the insurance company? A: Group association dental insurance is underwritten by
Madison National Life Insurance Company, Inc., a member of The IHC Group. Madison National is rated A- (Excellent) for financial strength by A.M. Best Company, Inc., a widely recognized rating agency that rates insurance companies on their relative financial strength and ability to meet their obligations. (An A++ rating from A.M. Best is its highest rating.) There is no ownership or affiliation between Madison National, Dentemax or NationalWay Assocation.
Q: How do I enroll? A: Members of NWHA may choose to participate in the
DentaCert Dental Plan as an advantage of membership. Enrollment is simple and can be completed with a representative, in person or over the phone. No health questions will be asked and acceptance is guaranteed.
A: T he Dental Provider Network is DenteMax which is one of the largest provider networks in America. To locate a dental provider in your area you can simply go to their website at www.dentemax.com or call customer service at 800-8107856.