NCD Nationwide
3000 Plan
- Underwritten by Nationwide
- Freedom to choose any dentist, but using Maximum Care Network will give you in-network benefits
- Maximum Care network is a national, seamless, credentialed PPO dental network, ranking in the top 10 for network size
- Coverage for you and qualified family members
- Coverage for preventive, basic and major services
- No Waiting Periods for preventive and basic services
- Guaranteed acceptance
- Low deductible limits
| Common procedures: | |
|---|---|
| Cleaning: | 100% |
| White Filling: | 80% |
| Crown: | 50% |
| Root Canals: | 50% |
| Simple Extractions: | 80% |
| Plan Maximum: | $3000 Annual Max, per insured person |
| Waiting Periods: | Preventive-None, Basic-None, Major-12 months* |
| Deductible: | $50 per person / $150 per Family - annual deductible for basic and major services |
| * Waiting period for major services may be waived with proof of prior coverage provided by the member. Proof of prior coverage will only be accepted from the prior carrier within 30 days of the effective date on NCD and showing 12 months of continuous fully insured coverage with no lapse. DHMO, discount, or scheduled plan coverage will not be accepted. Partial credit may also be given toward the waiting period with eligible continuous coverage less than 12 months. | |
| Details: |
|---|
| Fee Schedule: N/A | Dentist Search | Exams: |
| Routine periodic examinations (2 in 12 months) 100% Preventive – No waiting period | Cleanings: |
| Cleanings (2 in 12 months) 100% Preventive – No waiting period | X-Rays: |
| Radiography: Bitewing X-rays (1 per 12 months) 100% after deductible Preventive – No waiting period | Fillings: |
| Fillings: Restorative Amalgam Fillings Resin-based composite (white fillings) anterior only 80% after deductible Basic – No waiting period | Extractions: |
| Simple Extractions 80% after deductible Basic – No waiting period | Crowns: |
| Crowns (1 per tooth, per 7 years) 50% after deductible Major – 12-month waiting period | Root Canals: |
| Endodontics: Pulpal therapy and root canals 50% after deductible Major – 12-month waiting period | Dentures: |
| Dentures (1 appliance per 5 years) 50% after deductible Major – 12-month waiting period | Deep Cleanings: |
| Treatment of diseases of the gums, periodontal maintenance 50% after deductible Major – 12-month waiting period | Implants: |
| 50% after deductible Major – 12-month waiting period Implants are covered on teeth extracted while on the plan. Implants and implant supported prosthesis covered under this plan are limited to; 1) the replacement of permanent teeth extracted while insured under this plan, or 2) the replacement of a prior Implant if it has been at least seven years since the prior insertion and is not and cannot be made serviceable. | Braces/Orthodontia: |
| Not Covered Service | Teeth Whitening: |
| Not Covered Service | Additional Network Information: |
In Network NCD – Underwritten by Nationwide Insurance offers the use of Maximum Care PPO* which includes all Dentemax, Careington and Connection Dental network providers. Maximum Care PPO provides a national, seamless, credentialed PPO dental network, ranked in the top ten for network size with over 300,000 access points for your Dental Care needs. Maximum Care dentists offer fees below normal costs. Our NCD plan gives you the freedom to select any dentist you please, but if you use a Maximum Care network dentist, you may receive additional cost savings on fees to you and your family. Out-of-Network Out-of-Network benefits will be paid based on MAC fees. MAC means the Maximum Allowable Charge for your plan. You may be responsible for the difference between the MAC and the actual dental charge from a Non-Participating Provider. Network not required in NC, MA, VA and will be paid based on CMAC which is the Customary Maximum Allowable Charges for your plan. The freedom to select any dentist you please, but if you use a Maximum Care network dentist, you may receive cost savings on fees to you and your family. Exclusions and LimitationsPrivacy Policy Plan Brochure |
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?
A pre-existing condition is an oral health condition, which existed before your enrollment in a dental program.
Work in progress is any oral health procedure that is started and not completed prior to your enrollment in a dental program. The plan does not cover any treatments started prior to the date you are covered under this Policy.
The easiest way to determine if a service is covered is to utilize the Direct Faxback Service at 480-550-6440. You can also reach MBA directly by phone at 480-776-5041 M-F 8am-5pm PST. Pre-determinations should be submitted for any services expected to exceed $1000.00.
What provider options do I have?
The plan gives you the freedom to select any licensed dentist you please, but if you use the Maximum Care network and you choose a dentist in the network, you may receive cost savings on fees to you and your family.
Out-of-Network benefits will be paid based on MAC fees. MAC means the Maximum Allowable Charge for your plan. You may be responsible for the difference between the MAC and the actual dental charge from a Non-Participating Provider.
NCD is the name of your PPO dental plan, and your dental provider may not recognize the NCD name. Nationwide Life Insurance Company is the insurance company that underwrites the NCD dental plan. Most providers are used to working with PPO plans and should recognize the PPO networks MaximumCare PPO network, including Careington, Connection Dental, and Dentemax.
When can I start using my Plan?
You can start using your plan once it goes into effect - usually the 1st of the month following your enrollment (as long as the enrollment and payment is received within the enrollment deadline). Incomplete enrollment forms or failure to submit the required initial premium amount may cause an initial delay in issuance of insurance. Do not cancel any other insurance or assume you are insured under the Plan until you receive your certificate of insurance.
The frequency limitations begin on the first date of service for any given procedure. For example, if a member receives a bitewing X-ray (frequency limitation of 1 in 12 months) on April 5th, 2021, the member will not be eligible for another bitewing X-ray until April 5th, 2022.
When will I receive my new member kit and what will it include?
Your enrollment package will arrive in 7-10 days. It will include a new member trifold and ID card.
Who can enroll in this plan?
Coverage is offered to individuals who are 18 years of age and older, and their eligible dependents (spouse 18 years of age and older, and unmarried children from birth to age 26). As long as you meet the plan’s general eligibility requirements and pay the applicable premium, your acceptance is automatic.
When you enrolled in NCD, you automatically became a member of the National Small Business Association (NSBA)! The NSBA monthly membership fee is $3.00 and is included in your monthly billing.
You can now enjoy discounts, rewards, and perks on travel, apparel, restaurants, and much more. You can learn more about these benefits and services by visiting nsba.net and enter the access code “NSBA” under Member Login.
4201 Spring Valley Road, Suite 1500
Dallas, TX 75244
Disclaimers and Disclosures:
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.
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