Ameritas Dental Insurance: Is It the Right Choice for You?
Ameritas is an established insurance company in the United States that offers dental and vision insurance, along with life insurance and financial services. Its dental products are available to individuals, families, employers, and other eligible groups.
But is Ameritas dental insurance right for you? In this article, we review Ameritas dental plans to explain how much they cost, what they cover, and what you should consider before enrolling.
Quick Summary: Ameritas Dental Insurance
Ameritas Mutual Holding Company is a long-standing organization that provides dental and vision insurance, life insurance, and other financial products. Its individual dental plans include the PrimeStar range, with options offering different levels of preventive, basic, and major dental coverage.
| Recommended for | Not Recommended for |
|---|---|
| People who want individual dental coverage outside an employer-sponsored plan | People who need extensive adult orthodontic coverage |
| Customers who want preventive care and coverage for restorative dental procedures | People who expect insurance to pay the full cost of major procedures |
| Patients looking for plans that advertise no waiting periods for covered services | People whose preferred dentist charges substantially more than the plan’s payment allowance |
| Families interested in selected plans with child orthodontia benefits | People who want cosmetic treatments covered without checking policy exclusions |
| Customers who want annual maximums that increase after the first year on selected plans | Patients who expect every procedure to receive the highest benefit immediately |
What Is Ameritas Dental Insurance?
Ameritas dental insurance is part of Ameritas Mutual Holding Company. The company offers individual dental insurance plans, including PrimeStar Care Lite, PrimeStar Care Boost, and PrimeStar Care Complete.
The PrimeStar plans discussed in this article use a preferred provider organization (PPO) structure. This means you can visit an in-network or out-of-network dentist, but using an in-network provider may reduce your out-of-pocket costs.
Network providers have agreed to discounted fees, which can help lower the amount you pay for covered services. However, your actual costs depend on your plan, the dentist’s charges, the plan’s payment allowance, and any applicable deductible or annual maximum.
What Does Ameritas Cover?
Your coverage depends on the specific plan you choose. The following details are based on the dental-only PrimeStar quotes displayed on the Ameritas website for ZIP code 33548, Florida. Benefits and premiums may differ in other locations.
PrimeStar Care Lite
PrimeStar Care Lite is designed for people who want a plan emphasizing preventive care with more limited benefits for major procedures.
The quoted plan offers:
- Preventive care: 100% coverage for eligible examinations, cleanings, and bitewing X-rays.
- Basic services: 50% coverage on day one, increasing to 80% after the first year.
- Major services: 10% coverage on day one, increasing to 20% after the first year.
- Deductible: $50 per person for basic and major services combined.
- Annual maximum: $750 on day one, increasing to $1,500 after the first year.
Major services listed include root canals, crowns, bridges, dentures, and oral surgery, subject to the policy’s terms.
The plan also includes Preventive Plus, meaning eligible preventive procedures do not reduce the annual dental maximum available for basic and major services.
PrimeStar Care Boost
PrimeStar Care Boost offers broader coverage and additional benefits that may appeal to families.
The quoted plan includes:
- Preventive care: 100% coverage for eligible services.
- Basic services: 65% coverage on day one, increasing to 80% after the first year.
- Major services: 20% coverage on day one, increasing to 50% after the first year.
- Deductible: $50 per person for basic and major services combined.
- Annual maximum: $1,000 on day one, increasing to $2,500 after the first year.
- Implants: Maximum benefit of $500 on day one, increasing to $1,000 after the first year.If dental implants are a priority, compare Ameritas with other options in our guide to Delta Dental and the best dental insurance plans for implants.
- Child orthodontia: A lifetime maximum of $1,000 per child, subject to eligibility requirements.
- Teeth whitening: Listed as a benefit under the quoted plan, subject to the policy’s limitations.
Child orthodontia coverage applies to eligible treatment for children under age 19. Review the policy to confirm which procedures qualify and how the benefit is paid.
PrimeStar Care Complete
PrimeStar Care Complete offers a higher annual maximum and broader coverage for basic services, along with hearing benefits.
The quoted plan includes:
- Preventive care: 100% coverage for eligible services.
- Basic services: 80% coverage on day one, increasing to 90% after the first year.
- Major services: 20% coverage on day one, increasing to 50% after the first year.
- Deductible: $50 per person for basic and major services combined.
- Annual maximum: $2,000 on day one, increasing to $3,500 after the first year.
- Implants: Maximum benefit of $1,000 on day one, increasing to $1,500 after the first year.
- Hearing benefits: Coverage for eligible hearing examinations and hearing aids, subject to separate limits.
The hearing benefit has its own limits and is separate from the dental annual maximum. Under the quoted plan, eligible hearing examinations receive up to $75 per benefit period. Hearing-aid benefits have their own payment percentages, maximums, and eligibility rules.
Dental Rewards and Increasing Annual Maximums
Some Ameritas dental plans have offered a Dental Rewards program that allows eligible members to carry over part of their unused annual maximum. However, the PrimeStar plan details provided for this article emphasize increasing annual maximums instead.
For the quoted PrimeStar plans, the annual dental maximum increases after the first year. This can provide more financial protection for covered treatment in subsequent years, provided you maintain coverage and meet the policy requirements.
Do not assume that a Dental Rewards benefit applies to every current PrimeStar plan. Review the specific policy for details of any carryover benefit.
Overall, these plans provide different levels of coverage, with preventive care emphasized across the three options. The amount paid toward fillings, root canals, crowns, implants, and other procedures varies by plan and by how long you have been enrolled.
What Ameritas Doesn’t Cover
Ameritas dental insurance does not automatically cover every dental procedure. Coverage depends on the selected policy, its exclusions, limitations, and the treatment involved.
Common exclusions in the policy language supplied for this article include:
- Certain cosmetic procedures: Cosmetic treatment is generally excluded unless the policy specifically lists it as a covered benefit. PrimeStar Care Boost lists teeth whitening, so check the terms of that particular benefit.
- Replacement of dental restorations: Replacing crowns, inlays, onlays, veneers, or complete or partial dentures within five years of their previous placement may be excluded, unless an applicable exception applies, such as a qualifying accidental injury.
- Lost or stolen appliances: Replacement of lost or stolen dental appliances is excluded.
- Treatment started outside the coverage period: Procedures begun before coverage starts or after coverage ends may not be covered. Additional rules may apply to prosthetic appliances delivered after coverage terminates.
- Unlisted procedures: Treatment not included in the policy’s Table of Dental Procedures may not be covered.
- Certain restorative procedures: Appliances or procedures intended to alter vertical dimension, restore or maintain occlusion, or address tooth structure lost through abrasion or attrition may be excluded.
- Treatment that does not meet policy requirements: Services that are not considered necessary or that fall outside generally accepted standards of dental care may be denied.
- Certain replacement prostheses: Initial placement of a dental prosthesis or prosthetic crown may be excluded unless the policy’s conditions are met, including qualifying tooth extraction requirements.
Other limitations can apply, including coordination with workers’ compensation benefits and restrictions on charges for which the insured person is not legally responsible.
The exact exclusions vary by policy and state. Before treatment, review your policy documents and confirm whether the proposed procedure is covered.
Important Limitations and Exclusions to Know
Even when a dental procedure appears in a plan’s benefits list, the insurer may not pay the full amount charged by the dentist. Several limitations can affect your final out-of-pocket costs.
Annual maximums: The annual maximum is the amount the plan pays toward covered dental services during the applicable benefit period. Once the maximum is reached, you generally pay for additional covered treatment yourself.
Deductibles and coinsurance: A deductible may apply before benefits are paid for basic or major procedures. Coinsurance is the portion of an eligible charge you must pay after applying the plan’s benefit percentage.
Least-expensive appropriate treatment: If two or more procedures are considered adequate and appropriate under generally accepted dental standards, the policy may base the covered expense on the least expensive option. If you choose a more expensive alternative, you may need to pay the difference.
Treatment timing: Treatment begun before coverage starts may not be eligible for benefits. Similarly, treatment begun after coverage ends may be excluded. The policy also contains rules concerning certain dental appliances delivered after termination.
Provider and payment allowances: In-network providers may offer discounted fees, while out-of-network claims may use a different payment allowance. If your dentist charges more than the amount recognized by the plan, you may have to pay the difference.
State-specific exclusions: The policy language supplied includes a separate section for New York, with additional provisions concerning pre-existing conditions, services provided by family members, and other exclusions. These provisions should not automatically be applied to the Florida quote or to policies issued in other states. Check the contract applicable to your own location.
Before enrolling, ask the insurer to explain how these provisions apply to any treatment you expect to need.
Ameritas Dental Insurance Providers
Ameritas has an extensive dental provider network across the United States. Its PPO structure allows members to visit in-network or out-of-network dentists, although in-network care can offer additional savings.
According to the information displayed on the Ameritas website, network providers have agreed to charge approximately 25%–50% less than their regular rates for covered services. Actual savings vary by dentist, procedure, location, and plan.
The PrimeStar plans shown for ZIP code 33548 advertise no waiting periods for covered services and no enrollment fees. However, no waiting period does not mean every service receives its highest benefit immediately. The quoted plans offer lower coverage for some basic and major procedures during the first year, with higher benefits becoming available after the first year.
You can search for participating dentists through the Ameritas website. Before receiving treatment, confirm that the dentist accepts your specific plan and ask the office to verify your benefits.
Out-of-network coverage may also involve a different claim allowance. If your dentist charges more than the plan’s allowance, you may have to pay the difference.
Ameritas Dental Plans for Seniors
Ameritas individual dental plans may be an option for adults aged 65 and older who want help managing the cost of preventive and restorative dental treatment.
Depending on the plan, covered services may include examinations, cleanings, fillings, root canals, crowns, bridges, dentures, and other procedures. Coverage levels and annual maximums differ, so older adults should compare the benefits with their expected dental needs.
For seniors who anticipate needing extensive restorative work, a higher annual maximum may be useful. However, it is important to consider the premium, deductible, coinsurance, and plan limits together rather than choosing a policy based only on its maximum benefit.
People who are retired, self-employed, working part-time, or not eligible for employer-sponsored coverage may also wish to explore individual dental insurance.
Good oral health remains important throughout life. Untreated dental disease can affect eating, comfort, and quality of life, while some oral conditions are associated with wider health problems. Regular dental examinations can help identify problems before they become more difficult and expensive to treat.
How Much Does Ameritas Dental Insurance Cost?
The cost of Ameritas dental insurance varies by location, plan, and coverage selection. The following example uses the dental-only quotes displayed on the official Ameritas website after entering ZIP code 33548 in Florida.
Example: Ameritas Dental-Only Premiums in Florida
| PrimeStar plan | Monthly premium quoted | Annualized premium* | Annual dental maximum |
|---|---|---|---|
| PrimeStar Care Lite | $77.52 | $930.24 | $750 on day one; up to $1,500 after year one |
| PrimeStar Care Boost | $146.13 | $1,753.56 | $1,000 on day one; up to $2,500 after year one |
| PrimeStar Care Complete | $158.41 | $1,900.92 | $2,000 on day one; up to $3,500 after year one |
Annualized premium is calculated by multiplying the quoted monthly premium by 12. It is not a separate quote from Ameritas.
The three plans have a $50 deductible for basic and major services combined. Their benefits also increase after the first year.
Care Lite has the lowest quoted monthly premium of these three options. Care Boost adds benefits such as child orthodontia and limited implant coverage, while Care Complete offers a higher annual maximum, broader basic-service coverage, and hearing benefits.
These figures are an example of the prices displayed for ZIP code 33548, Florida, not nationwide prices or a guarantee that the same premiums will be available to every applicant. Prices and plan availability can change by state and location.
To check the current price for your own location, use the official Ameritas quote page. Make sure you select dental-only coverage if you do not want vision insurance included.
Some dental alternatives operate as discount plans rather than insurance policies. These generally work differently from PPO insurance, so compare how each option pays for treatment before making a decision.
Limitations on Orthodontia and Hearing Benefits
Some Ameritas plans offer additional orthodontic or hearing benefits, but these benefits have their own eligibility requirements and exclusions.
Child Orthodontia
The PrimeStar Care Boost quote lists child orthodontia benefits with a lifetime maximum of $1,000 per child. The policy language supplied includes the following limitations for orthodontic programs:
- Treatment generally must begin before the insured child’s 19th birthday.
- The orthodontic program must begin while the child is covered under the applicable benefit.
- Coverage may be limited to one orthodontic program during the insured person’s lifetime.
- The policy may calculate benefits based on metal brackets. If another material is used, benefits may be calculated as though metal brackets had been used.
- Treatment periods may need to fall within the coverage period for benefits to be payable.
- Repair or replacement of broken, damaged, lost, missing, or stolen orthodontic appliances may be excluded.
- Benefits may be affected if the patient does not follow the prescribed treatment program.
These restrictions come from the policy wording provided and should be checked against the specific orthodontic benefit in your plan. A lifetime maximum also means the available benefit does not automatically renew every year.
Hearing Benefits
PrimeStar Care Complete lists benefits for eligible hearing examinations and hearing aids. However, the hearing benefit does not cover every hearing-related expense.
The policy wording supplied identifies exclusions that may include:
- Hearing examinations performed before coverage begins or after it ends.
- Hearing tests required by an employer as a condition of employment.
- Medical or surgical treatment of the ear, including cochlear implants or ear tubes.
- Assistive hearing devices that are not listed in the policy’s Schedule of Hearing Care Services.
- Services performed by providers who are not appropriately licensed for the service.
- Services that do not relate to a qualifying conductive or sensorineural hearing loss.
- Charges for which the insured person is not legally responsible.
The quoted Care Complete plan lists up to $75 per benefit period for eligible hearing examinations. Hearing-aid coverage has separate limits, including a maximum that increases after the first year, subject to the policy’s conditions.
Because the hearing benefit has its own eligibility rules and maximums, review the full schedule before assuming a particular examination or device will be covered.
Ameritas Dental Insurance Reviews
What are others around the internet saying about Ameritas dental insurance?
Online reviews can help you understand members’ experiences with customer service, claims, and coverage. However, reviews may relate to different Ameritas products, including life insurance and group benefits, rather than the specific individual dental plan you are considering.
When reading Google reviews or other review platforms, look for comments that clearly describe dental insurance, such as problems with claims, benefit verification, reimbursement, or finding an in-network dentist. Consider both positive and negative feedback, and remember that individual experiences do not necessarily represent every member’s experience.
You should also compare reviews with the actual policy terms. A complaint about a procedure not being covered, for example, may relate to an exclusion, annual maximum, waiting period, or misunderstanding of the benefits.
Ameritas vs. Spirit Dental Insurance: Which Is Better?
Spirit Dental and Ameritas are not entirely separate alternatives: Spirit’s dental policies are underwritten or administered by Ameritas and use the Ameritas dental network. Nevertheless, their available plans and benefit structures can differ.
| Feature | Ameritas PrimeStar | Spirit Dental |
|---|---|---|
| Plan options | Care Lite, Care Boost, Care Complete, and other options depending on location | Several PPO and Flex options, depending on location |
| Waiting periods | The quoted PrimeStar plans advertise no waiting periods | Many plans advertise no waiting periods for covered services |
| Annual maximum | Up to $1,500 for Care Lite, $2,500 for Care Boost, and $3,500 for Care Complete after the first year | Some plans advertise annual maximums of up to $5,000 |
| Preventive care | The three quoted PrimeStar plans cover eligible preventive services at 100% | Coverage and the number of covered cleanings depend on the plan |
| Major procedures | Benefits increase after the first year on the quoted plans | Coverage varies by plan and service |
| Additional benefits | Selected plans offer implants, child orthodontia, teeth whitening, or hearing benefits | Selected plans offer benefits such as implants, child orthodontia, or hearing benefits |
| Best suited for | People who want to compare PrimeStar benefits and increasing annual maximums | People who want to compare different plan structures, including options with higher advertised annual maximums |
If you’re comparing Ameritas with other dental insurance providers, you may also want to read our guide to Ameritas vs. Humana Dental: Which Plan Suits You Best?. Neither company name alone tells you which policy offers the better value. Compare the premium, annual maximum, deductible, coverage for your expected procedures, provider network, and first-year benefits. Always check the specific policy available in your state.
Is Ameritas a Good Dental Insurance?
Ameritas may be a good option for people who want individual dental coverage, preventive benefits, and help paying for selected restorative procedures. The three PrimeStar plans described above provide different levels of coverage, allowing customers to compare premiums with annual maximums and additional benefits.
However, whether it is the right choice depends on your dental needs and budget. A lower-premium plan may be suitable if you mainly need preventive care, while a plan with a higher annual maximum may be more attractive if you expect more extensive treatment. Even with a higher maximum, you may still have substantial out-of-pocket costs.
Customer Service
Before enrolling, review Ameritas’ current customer-service contact details and claims procedures on its official website. If you already have a dentist, ask the office to check your benefits and explain how claims are handled under the exact plan you are considering.
Customer-service awards and historical performance statistics can be useful context, but older statistics should not be treated as proof of current service quality. Recent reviews and your own experience verifying benefits may be more relevant to your decision.
Customer and Provider Retention
A broad provider network can make it easier to find a dentist who accepts your plan. However, network size alone does not guarantee that your preferred dentist participates in your specific plan or that every procedure will be affordable.
Check your dentist’s current network status before enrolling and again before major treatment. If you expect to need a root canal, crown, implant, or another costly procedure, request a pretreatment estimate when available.
FAQ
Ameritas dental insurance offers individual and other dental coverage options. Its PrimeStar plans provide different levels of preventive, basic, and major dental benefits, depending on the policy and location.
For current contact information, use the official Ameritas contact page. If you are an existing member, use the contact details on your insurance card or policy documents for questions about your specific benefits.
The PrimeStar plans discussed in this article use the Ameritas Classic PPO network. Members may visit in-network or out-of-network dentists, but their costs can differ depending on the provider’s contracted rates and the plan’s payment allowance.
Some Ameritas plans list oral surgery among covered services. The amount paid depends on the plan, procedure, applicable benefit percentage, deductible, and annual maximum. Check your policy or request a pretreatment estimate before proceeding.
Root canals and crowns are listed under major services in the PrimeStar plans described here. Care Lite, Care Boost, and Care Complete pay different percentages, and benefits increase after the first year. Coverage is subject to the plan’s terms and maximums.
Coverage depends on the policy. Teeth whitening is listed in the supplied PrimeStar Care Boost plan details, but cosmetic procedures are generally excluded unless specifically included in the policy. Confirm the exact benefit and any limits before treatment.
Do not assume that adult orthodontics is covered. The Care Boost information supplied lists child orthodontia, and the policy language provided describes restrictions for orthodontic programs that begin before age 19. Check the policy for the plan’s exact eligibility requirements.
Conclusion
Ameritas offers several individual dental insurance options, including PrimeStar Care Lite, Care Boost, and Care Complete. Each plan differs in its premiums, annual maximums, coverage for basic and major procedures, and additional benefits. The Florida quote example shows that Care Lite has the lowest premium, while Care Boost and Care Complete offer higher annual maximums and additional benefits.
However, coverage remains subject to deductibles, annual maximums, exclusions, and other policy restrictions. Before enrolling, obtain a quote for your ZIP code, confirm your dentist’s network participation, and review coverage for your expected treatments. This will help you decide whether Ameritas offers the right balance of cost and coverage for your needs.
