|
Members (100 Plus Plans)
To locate a customizable plan, choose a group below.
100 Plus - Products and quality service offering
customizable plans, “the” flexibility, while
anticipating your needs.
Exclusive Provider Organization (EPO)
Preferred
Provider Organization (PPO)
Denex™
Indemnity Plan (Indemnity)
Outlook
Vision – Discount Vision Plan
Denex™
Value – Dental Discount Plan
Exclusive Provider Organization (EPO)
Our EPO Plan gives members access to a national network
of over 75,000 dental providers. Denex™ Dental will pay
a percentage of the charge by the Network Provider for
each covered service, up to the actual charge.
In-Network benefits are calculated based on the
participating provider’s negotiated fee. Members must
see a participating provider to be eligible for
benefits.
With our EPO Plan members enjoy the advantages of:
High quality service from credentialed providers.
Discounted fees for service.
Providers complete and submit claim forms on your
behalf.
No balance billing.
No referrals required to visit a specialist.
Contact our CCPs to identify services.
|
 |
Preferred Provider Organization (PPO)
Our PPO Plan is specifically designed to give each
member the “choice,” freedom and flexibility to visit
any licensed provider. However, since we have negotiated
discounted fees with our Network Providers, benefit
amounts will generally be higher if members receive care
In-Network. Our Network has both general dentists and
specialists to provide services.
With a national network of over 75,000 participating
providers, members enjoy the advantages of:
High quality service from credentialed providers.
Discounted fees for service.
Providers complete and submit claim forms on your
behalf.
No balance billing.
No referrals required to visit a specialist.
Denex™ Dental will pay a percentage of the charge by the
Network Provider for each covered service, up to the
actual charge. In-Network benefits are calculated based
on the participating provider’s negotiated fee.
Out-of-Network benefits are calculated using either a
Maximum Allowable Charge (based on fees paid to Network
Providers in the geographic area where the expenses are
incurred) or Reasonable and Customary Charge (as
determined by the Ingenix).
Providers that are not part of the Network have not
negotiated their fees with Denex Dental and will charge
their usual and customary fees.
To ensure proper savings, members should visit an
in-network provider. Or if you have any questions,
contact our CCPs for more information.
|
|
Denex™
Indemnity Plan (Indemnity)
Our Indemnity Plan gives members the freedom to see any
provider. Members simply choose a provider, obtain
services, and submit a copy of the bill with a claim
form to Denex Dental. Indemnity Plan benefits are
calculated using either a Maximum Allowable Charge
(based on fees paid to Network Providers in the
geographic area where the expenses are incurred) or
Reasonable and Customary Charge (as determined by the
Ingenix).
|
|
Outlook
Vision – Discount Vision Plan*
All Denex™ Dental members are automatically enrolled in
our Discount Vision Plan at no additional charge.
Members save on eyewear and eye care services from
participating vision centers.
Members receive:
Savings 10% to 50% off the retail price of eyewear
including prescription glasses, contact lenses, and
accessories.
Savings off standard fees on vision correction surgery
(Laser/Lasik) at select locations where approved.
Mail order contact lens replacement program that offers
a 10% to 50% discount.
Special discounts on eye exams at selected locations
where approved.
Free minor eye wear adjustments.
The Outlook Vision Network is comprised of over 11,000
national and regional providers such as Pearle Vision,
Sears Optical, LensCrafters, JC Penny Optical,
Eyemasters, independent optometrists or opticians, small
and large retail centers, “one-hour” service optical
centers, and many other eye care facilities. You can
locate a participating vision center by using the search
tool or by calling toll free at 1-866-433-6391.
Members simply take their Denex Dental ID Card to any
participating vision center. Members pay the discounted
amount directly to the provider at the time of purchase
and walk away with discounted savings. The Discount
Vision Plan is not insurance, so there’s no fuss, no
hassle, and no confusion – just the value of substantial
savings.
The Outlook Eyewear Guarantee:
Highest Quality – All merchandise is covered by
manufacturer’s warranty for materials and workmanship.
Price – Once purchase is made, if a member finds the
identical eyewear at a lower advertised price, the
difference will be cheerfully refunded.
Complete Satisfaction – If a member is not completely
satisfied with their eyewear purchase from a
participating vision center, it may be returned within
30 days for a full refund.
Contact our CSPs for approved selected locations.
|
|
Denex™
Value – Dental Discount Plan*
Our Denex Value Dental Discount Plan allows members to
see any provider that participates in the Network and
receive services at reduced, pre-negotiated discounts
that average 20% to 50% off the provider’s standard
fees. Members receive discounts from all participating
providers, including:
Orthodontists – Braces (for adolescents and adults)
Periodontists – Gums
Oral Surgeons – Wisdom Teeth
Prosthodontists – Bridges and Dentures
Pediatric Dentists – Child Treatment
Endodontists – Root Canals
Cosmetics – Veneers and tooth whitening
Denex Value is not insurance which makes using the plan
much easier. There are no exclusions or limitations on
procedures and members can use the plan as often as they
like. Unlike traditional dental insurance, they’re are
no administrative or claims forms and no red tape.
Members are automatically accepted when they join.
Using Denex Value is easy. Members simply choose a
participating provider and schedule an appointment.
Members can locate a current list of participating
providers by using the search feature on the website or
by calling a customer service representative. Members
show their ID Card and receive services at reduced,
pre-negotiated discounts far below the provider’s
standard fees.
* OUTLOOK Vision and Denex value are
not insurance. They are discount plans. You are
responsible for the full cost of any health care
services purchased. You will receive discounts for
medical services at certain health care providers who
have contracted with the plan. Members have the right to
cancel registration within a 30 period. This plan does
not make payments directly to health care providers. A
list of all plan providers within the prospective
member's service area which includes their name, city &
state, and medical specialty is available prior to
purchase, upon request. Discounts for hospital services
are not available. This plan is administered by Group
Dental Service of Maryland, Inc. (GDS-MD), your Discount
Medical Plan Organization, 111 Rockville Pike, Suite
950, Rockville, MD 20850, 866-433-6391,
www.denexdental.com. The plan and its administrators
have no liability for providing or guaranteeing service
or the quality of service rendered. |
