There are several types of dental plans available, each offering unique coverage on dental procedures, and types of services that are covered. We offer a variety of plans, allowing you to select the one that best matches your personal and family needs.

We encourage you to use this guide as an important resource to help you understand the options available prior to selecting a plan.

First, it’s important to identify the levels of coverage you will see in our plan options:

Understanding What’s Covered

• Preventive Dentistry covers services designed to maintain oral health and hygiene. Services covered under preventive care include routine check-ups, cleanings, x-rays and other services and procedures designed to prevent tooth decay and oral diseases.
• Restorative Dentistry covers services designed to treat decay and repair/maintain your teeth. Common services include procedures to restore damaged teeth, fillings, bridges, crowns, veneers and inlays.
• Major Restorative Dentistry covers major dental procedures including the replacement of missing natural teeth with dentures or bridges, and the repair of severely decayed or fractured teeth. Depending on your plan, oral surgery procedures may be covered.

We provide coverage for these services to encourage our members to receive the regular care needed to maintain proper oral health. Co-pays and specific coverage does vary by plan, so please refer to your schedule of benefits to fully understand your exact level of coverage.

We are committed to helping you understand your benefits and encourage you to contact us to discuss your plan coverage in detail. Call 1.877.760.2247 for a benefit review and our member services team will assist you in understanding your plan and help you to maximize your dental benefits.

For additional information on the cost of dental care in your area, please visit www.fairhealthconsumer.org

What Are the Different Types of Dental Plans offered by Solstice?

You’ll find that dental plans are set up similarly to medical plans. Most have a network of contracted providers, also known as in-network providers (which you can read more about here). Your choice of providers and your out-of-pocket costs will depend on the plan type you have selected.

Fee-for-Service: Members receive care from the dentist of their choice, and your co-payment at the dentist office are based on a fee for each service rendered.

Our Fee-for-Service plans are unique in that we are do not have rosters. In layman’s terms, this means that our members have the freedom to select any Solstice provider without having to be assigned to their office roster. This reduces your waiting time to be seen by a dentist, and allows for a higher standard of care and customer experience.

(Fee-for-Service plans are currently available to our group clients in the Northeast and Florida)

Dental Health Maintenance Organization (DHMO): Members pre-pay for dental benefits through their premiums and co-payments, and receive care through the Solstice network of dentists. Dental HMOs typically provide coverage for your basic care, reduce out-of-pocket costs and limit paperwork. (Offered to our individual and group clients)

Our DHMO plans are unique in that we are non-capitated without rosters. In layman’s terms, this means that our members have the freedom to select any Solstice provider without having to be assigned to their office roster. This reduces your waiting time to be seen by a dentist, and allows for a higher standard of care and customer experience.

Preferred Provider Organization (PPO): Network dentists agree to a negotiated fee schedule as payment for their services, and members are offered added discounts and incentives to use dentists who participate within the network. You may choose to receive services from any dentist but you will experience the highest level of savings by selecting an in-network dentist. (Offered to group clients)

For additional information on Dental Benefits, we recommend reading Dental Plan Basics provided by FAIR Health, an independent non-profit organization dedicated to consumer advocacy www.fairhealthconsumer.org.

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