STARMOUNT Dental Insurance
AlwaysCare ONEplus Individual and Family Dental & Vision Plans.
Up to nine fully insured dental plan options depending on your state
Optional Vision Insurance coverage for eye exams and materials available for eligible plans
- Brochures available when running a quote
National dental network with 270,000+ access points
National vision network that includes independent providers and retail chains
Hearing Savings Plan and Pharmacy Discount Card at no additional cost to policyholders
- No Application Fee
AlwaysCare Dental Plan Details
Each plan option pays a percentage of your cost for Preventative, Basic and Major services. The Network option also includes Orthodontic coverage.. The percentage paid and the annual benefit maximum increases according to the chart below.
|AlwaysCare PPO Plans|
|PLAN OPTIONS||INCREASING MAX||ULTIMATE MAX||PREVENTATIVE BASIC||CLEANING PLUS VISION|
|Deductible: Maximum 3 per family||$50 per year Applies to Basic and Major Services||No Deductible|
|Benefit Year Maximums: Per person, per benefit year||Year 1: $1,000||$2,000||$1,000||$1,000|
|Year 2: $1,250|
|Year 3+: $1,500|
|Coinsurance: Plan pays the following percentages of maximum allowable charges for each class **||Preventative: 100%|
|Basic: 80%||Basic: 70%||Basic: 50%||Plan covers routine exams and cleanings only|
|Major: 50%||Major: 40%|
|Waiting Periods||Preventative: None||Preventative: None||Preventative: None||Preventative: None|
|Basic: None||Basic: None||Basic: None|
|Major: 12 Months||Major:12 Months|
|Additional Features||At no additional cost: Hearing and Pharmacy Discount Card|
|* Plan availability varies by state.
** If you use an out-of-network dentist, benefits are paid based on the network-negotiated rate, and you may be billed for any remaining amount up to the billed charge.
- Routine exams and cleanings (2 per 12 months) 1 additional cleaning or periodontal maintenance per 12 months if member is in 2nd or 3rd trimester of pregnancy
- X-rays Bitewing x-rays (1 per 12 months)
- Full mouth/panoramic x-rays (1 per 24 months)
- Children’s services (up to age 16) Fluoride treatment (1 per 12 months) Sealants (1 per 36 months) Space maintainers (1 per 24 months)
- Adjunctive pre-diagnostic oral cancer screening (for age 40+)
- Simple restorative services (fillings)
- Simple extractions
- Emergency treatment
- Oral surgery (extractions and impacted teeth) & anesthesia (subject to review, covered with complex oral surgery)
- Repair of crown, denture or bridge
- Endodontics (root canals)
- Inlays and onlays
- Crowns, bridges, dentures and endosteal implants (in lieu of an approved 3-unit bridge)
Freedom of Choice
The national vision provider network includes independent optometrists and ophthalmologists, as well as regional and national retail chains (including Walmart Vision Center, Sam’s Club Optical, Costco,† Pearle Vision, Target, Sears, JCPenney and Visionworks). Also, you may choose different providers for
vision exam and materials purchases.
|Vision Services (In Network)|
|Exam (Once per 12 months||$15|
|Standard Plastic Lenses|
|(Once per 12 months)|
|Single Vision||Covered by Co-pay|
|Bifocal||Covered by Co-pay|
|Trifocal||Covered by Co-pay|
|Frames (Once per 12 months) Choose any frame available at provider locations||$120 retail frame|
|Contact Lenses (Once per 12 months) (Includes fit, follow-up and materials) In lieu of eyeglass lens & frames||$20 co-pay|
|- Elective||Up to $120 retail|
|- Medically necessary||Up to $210 retail|
When Does Your Coverage Start?
Your coverage start date is determined by the date the application is received.
- If your application is received on or before the 25th of the month, coverage will start on the 1st of the next month.
- If your application is received after the 25th of the month, coverage will start on the 1st of the following month.
The first premium payment will be processed immediately. Future premium payments will be processed automatically between the 2nd and 10th of the month for which premium is due.
Starmount Life Insurance Company and AlwaysCare Benefits, Inc. provide individual and group ancillary insurance and benefit administration. Together, the two have evolved into one of America’s most innovative and fastest-growing privately owned companies.
NOTICE: This provides a very brief description of some of the important features of the insurance policy. It is not the insurance policy and does not represent it. A full explanation of benefits, exceptions and limitations is contained in your Individual Dental Policy.
Yes, you have the freedom to keep your dentist. The Network option is a PPO network. A PPO network allows you to use a network or non network dentist.
With the PPO Network options, if you use a out of network dentist, you might have additional expenses out of pocket.
PPO stands for Preferred Provider Organization. The
The dentists that are in the network are contracted with the network and charge according to a discount fee schedule. This will provide you with a lower cost plan and lower amounts out of pocket.
If you use a dentist that is not in the PPO network, the insurance company will pay just like you are using a network dentist. If the dentist charges more, you may have more out of pocket.
Yes, you can have more than one dental plan. The insurance companies will coordinate benefits to make sure that the two plans combined are not paying the dentist more than the procedure charge.
You can also use a second plan to pick up when the other plan reaches it's annual maximum
If you have a discount dental plan, you can use it with the AlwaysCare Scheduled Fee option. If using the Network option, the discount plan can only be used if your dentist is outside of the PPO network.