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Bright Idea Dental 5000

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Affordable dental insurance from Bright Idea Dental.

$5,000 annual max. benefit. No Waiting periods for PREVENTIVE & BASIC services. No deductibles for preventive services. 


Product Details - schedule of benefits and coverage

$25 co-pay per office visit

 

PREVENTIVE CARE

  • Routine Exam (1 in 6 months)
  • Bitewing X-rays (1 in 6 months) 
  • Cleaning (1 in 6 months)
  • Fluoride for Children 19 and under (1 - 12 months)

 

100%

 

 

BASIC CARE

  • Full Mouth/Panoramic X-rays (1 in 3 years)
  • Sealants (age 13 and under)
  • Restorative Amalgams
  • Simple Extractions

 

80%

 

MAJOR CARE

  • Space Maintainers
  • Onlays
  • Implants
  • Crowns (1 in 10 years per tooth)
  • Crown Repair 
  • Endodontics (nonsurgical)
  • Periodontics (nonsurgical)
  • Periodontics (surgical)
  • Denture Repair 
  • Prosthodontics (fixed bridge; removable complete/partial dentures) (1 in 10 years) 
  • Complex Extractions
  • Anesthesia

 

50%

 

CLICK HERE to find the provider nearest to your location


Dental FAQ

Does My Dental Plan have a waiting period?
There are NO WAITING PERIODS for Preventive and Basic Dental Care!
There is a 12 month waiting period for Major Dental Care.
All benefits begin on your effective date. 

Who is eligible to purchase the plan?

The insurance coverage is available in states where it's approved to anyone age 18 and older. You can request coverage for your dependents; dependent eligibility varies based on state law.

Do I have coverage outside of the state I live in?
Yes, if you are traveling or have a covered dependent living in a different state, you will still have coverage. 

Are my rates guaranteed?
You will receive a 30-day notice prior to any rate change (more if required by state law).

How do I submit claims?
You or your dentist may submit completed claim forms along with any requested information to the address provided on your member id card. Dentists may submit claims electronically to the contact information provided on your member id card. You may also contact us directly for assistance. 

What if I want to cancel the policy?
All cancelations must be submitted in writing to 

Agentra
Attn: Dental Dept.
4201 Spring Valley Rd, Suite 1500 
Dallas, TX 75244  

OR by calling 800-979-8266. All Cancelation requests will be effective on the next billing period.

What is your refund policy?
You may only receive a refund provided you have submitted a written or verbal notice of cancellation to our office. This notice must be received prior to your policy effective date. No refunds are permitted once policy effective date has commenced. No refunds are permitted if any claims have been submitted or filed for any service or product for which you have been enrolled.

When will I receive my insurance id cards?
Member ID cards are generally shipped within 7-10 business days after your enrollment has been processed. Actual receipt of your id cards may vary, as all id cards are sent via USPS first class mail.

Replacement id cards may be requested by contacting member services at 1-800-979-8266. 

What if I have more questions?
Please contact your insurance agent.


Limitations & Exclusions

Reinstatement: If a member 's coverage terminates, they cannot re-enroll for 12 months from the date of termination.

Covered Expenses Will Not Include and No Benefits Will be Payable:
1. For any treatment which is for cosmetic purposes or to correct congenital malformations, except for medically necessary care and treatment of congenital cleft lip and palate.

2. To replace any prosthetic appliance, crown, inlay or onlay restoration, or fixed bridge within five years of the date of the last placement of these items, unless required because of an accidental bodily injury sustained while the Insured is covered. Replacement is not covered if the item can be repaired.

3. For initial placement of any prosthetic appliance or fixed bridge unless such placement is needed because of the extraction of natural teeth during the same period of continuous coverage. But the extraction of a third molar (wisdom tooth) will not qualify the item for payment. Any such appliance or fixed bridge must include the replacement of the extracted tooth or teeth. Coverage does not include the part of the cost that applies specifically to the replacement of teeth extracted prior to the period of coverage.

4. For addition of teeth to an existing prosthetic appliance or fixed bridge unless for replacement of natural teeth extracted during the same period of continuous coverage.

5. For any expense incurred or procedure began before the Insured’s current period of continuous coverage.

6. For any expense incurred or procedure begun after the Insured’s insurance under this section terminates, except for a prosthetic appliance, fixed bridge, crown, or inlay or onlay restoration for which both (a) the procedure begins before insurance ends and (b) the item’s final placement is within 90 days after insurance ends.

7. To duplicate appliances or replace lost or stolen appliances.

8. For appliances, restorations or procedures to:
a. alter vertical dimension;
b. restore or maintain occlusion;
c. splint or replace tooth structure lost as a result of abrasion or attrition; or
d. treat jaw fractures or disturbances of the temporomandibular joint.

9. For education or training in, and supplies used for, dietary or nutritional counseling, personal oral hygiene or dental plaque control.

10. For broken appointments or the completion of claim forms.

11. For orthodontia service or for any services associated with orthodontic therapy when this optional coverage is not elected and the premium is not paid.

12. For sealants which are:
a. not applied to a permanent molar;
b. applied before age 6 or after attaining age 16; or
c. reapplied to a molar within three years from the date of a previous sealant application.

13. For subgingival curettage or root planing (procedure numbers 4220 and 4341) unless the presence of periodontal disease is confirmed by both x-rays and pocket depth summaries of each tooth involved.
v14. Because of an Insured’s injury arising out of, or in the course of, work for wage or profit.

15. For an Insured’s sickness, injury or condition for which he or she is eligible for benefits under any Workers Compensation Act or similar laws.

16. For charges for which the Insured is not liable or which would not have been made had no insurance been in force.

17. For services which are not recommended by a dentist, not required for necessary care and treatment, or do not have a reasonably favorable prognosis.

18. Because of war or any act of war, declared or not, or while on full-time active duty in the armed forces of any country.

19. To an Insured if payment is not legal where the Insured is living when expenses are incurred.

20. For any services related to equilibration, bite registration or bite analysis.

21. For crowns for the purpose of periodontal splinting.

22. For charges for any overdentures; precision or semi-precision attachments and associated endodontic treatment; other customized attachments; or specialized prosthodontic techniques or characterizations.

23. For charges for myofunctional therapy, orthognathic surgery or athletic mouthguards.

24. For procedures for which benefits are payable under the employer’s medical expense benefits plan for employees and their dependents.

25. Services or supplies provided by a family member or a member of the Insured’s household.

Note: This is a general outline of covered benefits and does not include all the benefits, limitations and exclusions of the policy. See your certificate for details.

Predetermination of Benefits: As a service to protect the Insured, First Continental Life & Accident Insurance Co. will provide predetermination of benefits for recommended treatment plans that exceed $300. This predetermination of benefits explains which of the recommended procedures will be covered and at what amount. This benefit helps insureds better understand their coverage. The Insured should submit the treatment plan to First Continental Life & Accident Insurance Co. for review and predetermination of benefits before the service begins.

 

MICHAEL OLDFIELD

COOL INSURANCE GROUP, LLC
3408 CRIMSON KING COURT
LEXINGTON, KY 40517
PHONE: (859) 654-0120
TOLDFIELD@COOLINSURANCEGROUP.COM

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