IEHP Dental Insurance: A Comprehensive Guide

Author

Reads 955

Woman Having Dental Check-up
Credit: pexels.com, Woman Having Dental Check-up

IEHP dental insurance is designed to provide comprehensive coverage for its members. IEHP offers a range of dental plans to suit different needs and budgets.

IEHP dental insurance covers a wide range of dental services, including routine cleanings, fillings, and extractions. This coverage helps prevent and treat oral health issues.

IEHP members can choose from various dental plans, including PPO and HMO options. These plans offer flexibility and convenience in choosing a dentist.

If this caught your attention, see: Dual Dental Insurance Coverage for Orthodontics

What IEHP Covers

IEHP covers dental implants, but only if you meet certain criteria.

To be eligible, you need to have lost or deteriorating natural teeth due to an accidental injury, disease, or defect.

Other non-surgical treatments must have been deemed ineffective.

You'll need documented evidence of medical necessity from a treating physician or dentist.

The treatment proposed must be recognized as safe and proven clinically effective.

IEHP offers coverage up to $3,000 per benefit period (usually one year) towards costs associated with medically necessary procedures.

Credit: youtube.com, Dental Benefits for members of IEHP DualChoice Cal MediConnect Plan

This includes surgical placement of endosteal or subperiosteal implants, as well as reconstructive surgery related to implant complications.

You must obtain prior approval from MHSM before undergoing any procedures.

If approved, you'll pay only 50% co-insurance instead of the usual 20%.

Any amount over $3,000 will be your responsibility.

This maximum benefit also includes other associated costs like bone grafting (if required), imaging studies such as x-rays or CT scans.

Coverage Details

IEHP covers dental implants, but you need to meet certain criteria to be eligible for coverage. Generally, IEHP provides coverage for medically necessary dental treatments that affect an individual's overall well-being and ability to function in daily life.

To be eligible, you must have lost or deteriorating natural teeth due to an accidental injury, disease, or defect. You'll also need to have tried other non-surgical treatments that were deemed ineffective.

IEHP requires documented evidence of medical necessity from a treating physician or dentist. The treatment proposed must also be recognized as safe and proven clinically effective.

Credit: youtube.com, Dental Benefits for members of IEHP DualChoice Cal MediConnect Plan (ENG) AD

IEHP offers coverage up to $3,000 per benefit period towards costs associated with medically necessary procedures like surgical placement of endosteal or subperiosteal implants. This includes other associated costs like bone grafting and imaging studies.

You must obtain prior approval from MHSM before undergoing any procedures. If approved, you'll pay only 50% co-insurance instead of the usual 20%. Any amount over $3,000 will be your responsibility.

IEHP's maximum benefit includes costs associated with reconstructive surgery related to implant complications.

The Basics of

IEHP Dental Insurance is a type of health insurance that covers dental care.

IEHP Dental Insurance offers a range of plans to choose from, including the IEHP Dental 100 plan, which covers 100% of dental costs.

IEHP Dental Insurance is available to individuals, families, and small businesses.

IEHP Dental Insurance has a network of participating dentists, including specialists like orthodontists and oral surgeons.

IEHP Dental Insurance covers a wide range of dental services, including routine cleanings, fillings, and extractions.

IEHP Dental Insurance requires a copayment for some services, but many services are covered at 100%.

IEHP Dental Insurance also offers additional benefits, such as coverage for dental X-rays and fluoride treatments.

Limitations and Criteria

Credit: youtube.com, We Explain Dental Insurance Limitation of Benefits | View Mobile Dental

To be eligible for IEHP's dental implant coverage, you must be an active member of IEHP with active dental coverage at the time of the procedure.

IEHP only covers dental procedures for individuals over 18 years old, with exceptions made for children who have lost permanent teeth due to trauma or congenital defects.

Your dentist must diagnose you with a missing tooth or teeth that require replacement via implants.

A treatment plan outlining the necessity of dental implants, as well as the expected procedures and costs, must be submitted by your dentist.

Prior authorization is required from IEHP before undergoing any major procedures such as dental implants.

IEHP will not cover all costs associated with dental implants, so you may need additional financial support from other sources like personal savings or payment plans offered by your dentist.

IEHP has limitations on the coverage for dental implants, including the number of implants allowed and specific criteria for eligibility.

Pediatric Services

Credit: youtube.com, IEHP Medi-Cal for Uninsured

IEHP dental insurance covers pediatric dental services until the last day of the month in which the individual turns 19 of age. This means that your child's dental care is well-covered until they reach adulthood.

You can rest assured that your child's dental health is a top priority with IEHP.

Cost and Payment

IEHP Dental Insurance offers a range of plans to fit different budgets and needs.

The cost of IEHP Dental Insurance varies depending on the plan you choose, with premiums starting at around $20 per month for the most basic plan.

You can pay your premiums online, by phone, or by mail, with options for automatic payment to ensure you never miss a payment.

IEHP Dental Insurance also offers a 30-day free look period, allowing you to review your policy and cancel it if you're not satisfied.

If you cancel your policy, you'll typically receive a full refund of your premium if you've made no claims.

Frequently Asked Questions

What does IEHP not cover?

IEHP does not cover non-medical visits, including trips to government offices, courts, and social services. This includes visits for Social Security, Workers Compensation, Personal Injury cases, and more.

What is the most dental insurance will cover?

Most dental insurance plans cover 100% of preventive care, including routine check-ups and cleanings. Basic coverage typically covers essential services like fillings and extractions, as well as some diagnostic tests.

Is IEHP the same as Medi-Cal?

No, IEHP is not the same as Medi-Cal, but they work together to provide services and benefits. IEHP is a managed care plan for Riverside and San Bernardino counties, part of the Medi-Cal program.

Tommy Weber

Lead Assigning Editor

Tommy Weber is a seasoned Assigning Editor with a keen eye for detail and a passion for storytelling. With extensive experience in assigning articles across various categories, Tommy has honed his skills in identifying and selecting compelling topics that resonate with readers. Tommy's expertise lies in assigning articles related to personal finance, specifically in the areas of bank card credit and bank credit cards.

Love What You Read? Stay Updated!

Join our community for insights, tips, and more.