Highlights of the program features are listed below. Click, the "Details" button for additional information on the benefits, including exclusions and limitations.
Click here to download the pdf brochure.
When you or your child are ill in the middle of the night, or at any time, it is now at your fingertips to get professional help. Speak with a caring staff of registered nurses toll-free, 24 hours a day, 7 days a week.
• It’s midnight and the baby has been crying for hours
• Your child hurt their knee while playing
• You have been newly diagnosed with diabetes
You are only a phone call away from immediate referral to your choice of over 20,000 attorneys, and 6,900 law firms nationwide. You are entitled to:
Plan Details: You receive the following benefits: NO Deductible for Type 1 Preventive Services, $50 Deductible for Type 2 Basic Services, Maximum Benefit – $2,500 annually Per Family Member, Benefits Are Paid Based On Schedule of Eligible Expenses, No waiting period on preventive and basic services, Choose any dentist nationwide or select from one of nearly 475,000 provider access locations.
• Our Participating Provider Organization [PPO] gives you access to a nationwide network of credentialed providers.
• With our dental plans, you may always receive care from any provider you choose; however, your out-of-pocket costs will almost always be lower if you choose a provider from our PPO dental network.
• Our PPO network dentists agree to charge only a specific amount per procedure; they provide the same excellent service at a reduced fee, resulting in savings for you.
• Benefits can be the same whether the plan member visits a network or out-of-network provider. The difference is the remainder the member must pay after benefits are applied.
Find a Provider (Select Classic PPO)
*These insurance benefits are issued on Form Series 9000 Rev.4-13, are underwritten by Ameritas Life Insurance Corp., a NE domiciled life insurance company with main offices located at 5900 O Street, Lincoln, NE 68521. Licensed in all states except NY. This product, and its features are subject to state availability and may vary by state. Certain exclusions and limitations may apply, for cost and complete details of coverage, please contact us or your agent. These insurance benefits are not available in AK, KS, MT, NH, NY, RI, SD, WA and UT.
*Ameritas Life Insurance Corp. (“Ameritas”) provides the Dental and Vision coverage and access to the AXA program. Ameritas does not provide nor is it affiliated with any of the other programs provided as a part of the membership in USA+.
The association membership fee for dental (and vision when applicable) you will be charged includes the following insurance rates, which are paid to Ameritas: Member Only/ $9.06 Member + 1/ $9.06 Member + Family/ $9.06
Dental Rewards - Rewards insureds that care for their teeth and use only a portion of their annual maximum benefit in a year. With its increasing maximum feature, each insured member and dependent earns additional money toward his or her next year’s annual maximum.
To get the maximum carryover for the next year, you must meet the following requirements:
1) Visit your Dentist between Jan. 1st and Dec. 31st.
2) Submit claim for payment prior to April 1st of the next year.
3) Total benefits paid for current year visits must be less than $500.
• If you meet all 3 requirements you will have an additional $250 available in Annual Maximum
for the next year.
• As long as you continue to visit the Dentist each year the $250 will be available.
• In future years if you have benefits paid of less than $500, additional amounts of $250 will
be added to the carryover. However, the most you can accumulate in the maximum carryover is $1,000.
• Your annual maximum will be $3,500 in four years if you continue to visit the dentist once
each year!
*These insurance benefits are issued on Form Series 9000 Rev.4-13, are underwritten by Ameritas Life Insurance Corp., a NE domiciled life insurance company with main offices located at 5900 O Street, Lincoln, NE 68521. Licensed in all states except NY. This product, and its features are subject to state availability and may vary by state. Certain exclusions and limitations may apply, for cost and complete details of coverage, please contact us or your agent. These insurance benefits are not available in AK, KS, MT, NH, NY, SD and UT.
*Ameritas Life Insurance Corp. (“Ameritas”) provides the Dental and Vision coverage and access to the AXA program. Ameritas does not provide nor is it affiliated with any of the other programs provided as a part of the membership in USA+.
The association membership fee for dental (and vision when applicable) you will be charged includes the following insurance rates, which are paid to Ameritas: Member Only/ $9.06 Member + 1/ $9.06 Member + Family/ $9.06
Ameritas In Network Provider | Typical Out of Network Charge | ||
Type 1 | Exam D0120 | $27 | $66 |
Cleaning D1110 | $55 | $113 | |
Ameritas Pays | |||
Exam D0120 Schedule Allowance | $17 | $17 | |
Cleaning D1110 Schedule Allowance | $36 | $36 | |
Member Out of Pocket | In Network | Out of Network | |
Member Pays | $29 | $126 | |
Type 2 | Bitewing X-ray D0272 | $23 | $57 |
Resin-based composite filling D2330 | $80 | $211 | |
Ameritas Pays | |||
Annual Deductible* | $50 | $50 | |
Bitewing X-ray D0272 Schedule Allowance | $10 | $10 | |
Resin-based composite filling D2330 Schedule Allowance | $38 | $38 | |
Member Out of Pocket | In Network | Out of Network | |
Member Pays | $105 | $270 |
Figures based on a Dallas, Texas, ZIP Code may not reflect fees charged in other areas.
Covered Expenses will not include and benefits will not be payable for expenses incurred:
1. for initial placement of any prosthetic crown, appliance, or fixed partial denture unless needed because of the extraction of one or more teeth while the insured person is covered
under this contract. But the extraction of a third molar (wisdom tooth) will not qualify under the above. Any such prosthetic crown, appliance, or fixed partial denture must include the replacement of the extracted tooth or teeth.
2. for appliances, restorations, or procedures to:
a. alter vertical dimension;
b. restore or maintain occlusion; or
c. splint or replace tooth structure lost as a result of abrasion or attrition.
3. for any procedure begun after the insured person’s insurance under this contract terminates; or for any prosthetic dental appliances installed or delivered more than 90 days after the Insured’s insurance under this contract terminates.
4. to replace lost or stolen appliances.
5. for any treatment which is for cosmetic purposes.
6. for any procedure not shown in the Table of Dental Procedures. (There may be additional frequencies and limitations that apply, please see the Table of Dental Procedures for details.)
7. for orthodontic treatment under this benefit provision. (If orthodontic expense benefits have been included in this policy, please refer to the Schedule of Benefits and Orthodontic Expense Benefits provision found on 9260).
8. for which the Insured person is entitled to benefits under any workmen’s compensation or similar law, or charges for services or supplies received as a result of any dental condition caused or contributed to by an injury or sickness arising out of or in the course of any employment for wage for profit.
9. for charges which the Insured person is not liable or which would not have been made had no insurance been in force.
10. for services that are not required for necessary care and treatment or are not within the generally accepted parameters of care.
11. because of war or any act of war, declared or not.
You receive the following vision benefit: One eye exam once per year per family member from participating providers or $47 towards an exam for non participating providers. There are 37,000 VSP providers and 5,000 retail locations nationwide. Find a VSP provider near you at vsp.com.
*These insurance benefits are issued on Form Series 9000 Rev.4-13, are underwritten by Ameritas Life Insurance Corp., a NE domiciled life insurance company with main offices located at 5900 O Street, Lincoln, NE 68521. Licensed in all states except NY. This product, and its features are subject to state availability and may vary by state. Certain exclusions and limitations may apply, for cost and complete details of coverage, please contact us or your agent. These insurance benefits are not available in AK, KS, MT, NH, NY, RI, SD and UT.
*Ameritas Life Insurance Corp. (“Ameritas”) provides the Dental and Vision coverage and access to the AXA program. Ameritas does not provide nor is it affiliated with any of the other programs provided as a part of the membership in USA+.
The association membership fee for dental (and vision when applicable) you will be charged includes the following insurance rates, which are paid to Ameritas: Member Only/ $9.06 Member + 1/ $9.06 Member + Family/ $9.06
EXCLUSIONS - VISION
This plan does not cover:
· Services and/or materials not specifically included in this Schedule as covered Plan Benefits,
· Plano lenses (lenses with refractive correction of less than plus or minus .50 diopter) except as specifically allowed in the frames benefit section below,
· Services or materials that are cosmetic, including Plano contact lenses to change eye color and artistically painted Contact Lenses,
· Orthoptics or vision training and any associated supplemental testing,
· Medical or surgical treatment of the eyes,
· Local, state and/or federal taxes, except where law requires us to pay
For more information, call USA+ Member Services at 1-800-872-1187 or visit our website at www.usahc.com for online benefit information.
Find A Provider (Select Classic PPO)
Easy as 1…2…3…
By using a VSP provider, there is no paper work or claim to file. The member simply makes an appointment with a VSP doctor, states that they have VSP coverage, and visits the doctor. VSP handles the rest! Your Ameritas VSP identification number can be found on your ID card.
Vision Service Plan brings tremendous value to the United Service Association For Health Care Benefits! For more information, call the VSP Member Services number at 1-800-877-7195 or visit the USA+ website www.usahc.com and select the “Members Only” tab and when prompted, enter your user ID and password (login instructions listed on webpage) for online benefit information.
When our members travel abroad, they will have peace of mind knowing that should a dental or vision need arise, help is just a phone call away. Through AXA Assistance, Ameritas now offers its dental and vision plan members access to dental or vision provider referrals when traveling outside the U.S. AXA Assistance USA is part of a global organization with offices in more than 30 countries, where AXA Assistance professionals answer calls 24 hours a day. Immediately after a call comes in, an assistance coordinator assesses the situation, provides credible provider referrals and can even assist with making the appointment. Within 48 hours following the appointment, the coordinator calls the member to find out if additional assistance is needed. If all is well, the case is closed. Then, the plan member may submit a claim to Ameritas for reimbursement consideration based on applicable plan benefits.
Providers referred by AXA Assistance USA, Inc. (AXA) are not members of the Ameritas Life Insurance Corp. (Ameritas) PPO Network. Referral to an AXA provider is not a guarantee of benefits, and all policy provisions and limitations would apply.
Note: These provider referral assistance services are independently offered and administered by AXA. Ameritas and its affiliates and subsidiaries do not participate in the selection of these dental and vision service providers and do not oversee or monitor AXA’s performance of these services. Additionally, Ameritas does not warrant or guarantee or make any representation as to the quality of the services provided by AXA or by any dental or vision services provider referred by AXA.
Membership in USA+ is NOT insurance nor is it meant to represent an insurance contract. Some of the benefits available to our members are NOT Insurance. This is an Association Membership offered and administered by United Service Association For Health Care. As added membership benefits, all active members are automatically covered under certain group insurance policies purchased by USA+. The benefits are underwritten by A.M. Best rated insurance companies and subject to the exclusions, limitations, terms and conditions of coverage as set forth in the insurance certificate provided in your membership materials and the Policy issued to USA+. Please contact USA+ for state availability. Not available in all states.
This product is not in any way associated with, nor does it meet, the pediatric dental requirement of the Patient Protection and Affordable Care Act (i.e., ACA, Obamacare, etc.)
You have 30 days (or such longer period as may be required by state law) to review and evaluate the USA+ membership. If you wish to cancel your membership and receive a full refund, you may do so by submitting a written request to USA+ at the address listed below.
(800) 872-1187 and info@usahc.com