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Unmatched Dental and Vision Insurance Plans in Huntington Beach, CA

Enjoy the freedom to smile brighter and see clearer with the peace of mind from knowing you are protected. DIA offers comprehensive dental and vision insurance plans in Huntington Beach, CA, perfect for you and your loved ones. Our personalized plans offer various benefits without burdening you with high costs. 

All About Dental Coverage

Choosing the Right Category 
There are several different types of individual, family, or group dental insurance plans grouped into the following:
  • Indemnity: Also known as true dental insurance, this liberating option grants you the freedom to choose any dentist accepting coverage. 
  • Preferred Provider Network (PPO): This plan lets you enjoy the advantages of a curated network of dentists, balancing choice and cost-effectiveness. 
  • Dental Health Managed Organizations (DHMO): It offers a structured dental care ecosystem where you are seamlessly connected to an in-network dentist or dental office to receive your benefits.
Understanding Dental Insurance Fee Schedules
Dental offices generally have a fee schedule that lists rates for their services or procedures. Insurance companies use a similar structure based on usual and customary dental services, reflecting an average of the fees within your locality.
In-Network vs. Out-of-Network Providers
When a dentist signs a contract with a dental insurance company, the provider agrees to match the insurance fee schedule, offering their customers a reduced service cost. This arrangement forms what is known as an in-network provider or participating provider network (PPO).
However, if you seek services from an out-of-network or non-participating provider under specific plans, any fee differences will typically become the patient's financial responsibility. This remains true unless otherwise specified in the dental policy.
Waiting Periods 
Specific dental insurance plans may have waiting periods before some benefits are covered. This restriction is generally set for new enrollees or those seeking independent plans outside an employer or group policy.
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Annual Maximum Benefit Limit
Some dental insurance plans have an annual maximum benefit limit. Once this limit is reached, the cost of additional treatments might need to be covered by the patient. This maximum is reset yearly, with the date varying by calendar year, company fiscal year, or enrollment date, depending on the specific plan.
Coverage Categories and Deductibles
Dental services are categorized and coded by the American Dental Association (ADA). Coverage can vary significantly:
  • Preventative and Diagnostic: This typically includes exams (ADA Code 0120), x-rays (ADA Code 0210), and basic cleanings (ADA Code 1110).
  • Basic Procedures: Fillings, periodontics, endodontics, and oral surgery
  • Major Procedures: This category often covers crowns, dentures, and implants, with some plans categorizing periodontics, endodontics, and oral surgery as major procedures based on specific fee schedules and co-payments.
Additionally, depending on the treatment type, some plans may impose an annual deductible. After meeting this deductible, the dental plan covers the benefits at specified percentages or fee schedules.
Preventative Care and Limitations
Many dental plans offer free semi-annual preventative treatment, though services like fillings, crowns, implants, and dentures may be subject to various limitations.
Enrollment and Claims Process
Upon enrolling in a plan, members receive an identification or policy number. Services rendered lead to claims filed with the insurance provider. Enrollees must review their benefit packets carefully to understand coverage details and contact their provider or insurance company for specific benefit questions. Eligibility of benefits (EOB) statements are typically sent after treatment, detailing payments made.

All About Vision Coverage

Vision insurance is designed to cover services provided by eye care professionals, including ophthalmologists and optometrists. Coverage often includes:
  • Yearly eye examinations
  • Partial or complete coverage for eyeglasses, sunglasses, and contact lenses
  • Various copays, depending on the chosen plan
It aims to make eye care more affordable and accessible to encourage regular examinations and necessary corrective measures.

Ask About Our Insurance Packages

Invest in a confident, worry-free journey to optimal care with our insurance plans. Contact us today to learn more about what we offer.