Renaissance
MAX Choice Plus
- No age limits
- No waiting periods on any services
- Preventive procedures covered at 100%
- Immediate coverage for Basic Services that escalates to 80% in the third year
- Immediate coverage for Major Services that escalates to 50% in the third year
- Orthodontic Coverage up to age 19 that escalates to 50% in the third year
- Annual Plan Maximum that escalates to $3000 in the third year
Access to over 200,000 nationally credentialed dental PPO provider access points. While you may save the most money by visiting a dentist in our vast network, you are welcome to visit any licensed dentist in the country.
| Common procedures: | |
|---|---|
| Cleaning: | 100% |
| White Filling: | 20%-50% |
| Crown: | 20%-50% |
| Root Canals: | 20%-50% |
| Simple Extractions: | 20%-50% |
| Plan Maximum: | 1st Year – $1000 2nd Year – $2000 3rd Year and after – $3000 Orthodontia lifetime maximum – $1200 per person |
| Waiting Periods: | None |
| Deductible: | Annual Deductible: $50 per person/$150 per family for Basic and Major Services Only. The Deductible does not apply for Diagnostic and Preventive or Orthodontic Services |
| Details: |
|---|
| Fee Schedule: N/A | Dentist Search | Exams: |
| Routine periodic examinations twice in a calendar year 1st Year – 100% 2nd Year – 100% 3rd Year and after – 100% Preventive – No waiting period | Cleanings: |
| Teeth Cleanings – twice in a calendar year 1st Year – 100% 2nd Year – 100% 3rd Year and after – 100% Preventive – No waiting period | X-Rays: |
| Bitewing X-rays are payable once per calendar year (Full mouth X-rays covered under Major Services and payable once in any five-year period) 1st Year – 40% after deductible 2nd Year – 60% after deductible 3rd Year and after – 80% after deductible Basic – No waiting period | Fillings: |
| 1st Year – 20% after deductible 2nd Year – 40% after deductible 3rd Year and after – 50% after deductible Major – No waiting period | Extractions: |
| 1st Year – 20% after deductible 2nd Year – 40% after deductible 3rd Year and after – 50% after deductible Major – No waiting period | Crowns: |
| Crowns are payable once per tooth per five-year period 1st Year – 20% after deductible 2nd Year – 40% after deductible 3rd Year and after – 50% after deductible Major – No waiting period | Root Canals: |
| 1st Year – 20% after deductible 2nd Year – 40% after deductible 3rd Year and after – 50% after deductible Major – No waiting period | Dentures: |
| Dentures are payable once per tooth per five-year period 1st Year – 20% after deductible 2nd Year – 40% after deductible 3rd Year and after – 50% after deductible Major – No waiting period | Deep Cleanings: |
| Periodontic Services – Used to treat diseases of the gums and supporting structures of the teeth 1st Year – 20% after deductible 2nd Year – 40% after deductible 3rd Year and after – 50% after deductible Major – No waiting period | Implants: |
| 1st Year – 20% after deductible 2nd Year – 40% after deductible 3rd Year and after – 50% after deductible Major – No waiting period | Braces/Orthodontia: |
| Orthodontic benefits are only available for eligible dependent children up to age 19 1st Year – 10% 2nd Year – 25% 3rd Year – 50% $1200 lifetime maximum per person for this benefit | Teeth Whitening: |
| Not Covered Service | Additional Network Information: |
Individuals may visit any dentist, but will receive the best benefits by seeing a dentist who participates in the Renaissance PPO network. Individual claims will be paid based on Renaissance Dental’s PPO Fee Schedule. This means individuals seeking the lowest out-of-pocket costs should visit a PPO dentist. Out-of-network fees are paid based on PPO Fee Schedule. Billing and eligibility administration provided by Morgan-White Administrators, Inc. 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. The plan does not include an exclusion for pre-existing conditions.
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 expenses prior to the date you are covered under the Policy.
What provider options do I have?
The plan gives you the freedom to select any licensed dentist you please, but if you use the Renaissance PPO 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.
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.
When will I receive my new member kit and what will it include?
You will receive your enrollment package upon completion of enrollment and payment of applicable premiums/enrollment fees, or a few days prior to the selected effective date. The enrollment package will include your Certificate of Coverage and I.D. cards and is sent via email from noreply@morganwhite.com.
Who can enroll in this plan?
You may enroll yourself and your eligible dependents. Dependents named in the application must be approved by Renaissance Dental as eligible. Specific criteria for dependent eligibility may vary by state.
As long as you meet the plan’s general eligibility requirements and pay the applicable premium, your acceptance is automatic.
P.O.Box 17250
Indianapolis, IN 46217
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.
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