Level Dental Plans
Level’s PPO dental plans provide comprehensive (100%) coverage for medically necessary dental services, up to the annual maximum. Some plans may include coinsurance for basic, major, and orthodontic care. There is no waiting period or missing tooth clause, so members can use their benefits immediately once their plan is active. Verify member coverage prior to appointments using the free Provider Dashboard.
Using the Level Visa Card
For patients on a Level plan with card support, use the Level Visa Card for instant claim payment. Following the purchase, make sure to provide the member with an itemized receipt i.e. statement of services or actual completed claim. Document(s) should also include the Tax ID, address and treating provider along with service lines and authorizations
Confirm network status
While members can use their dental benefits at any provider in the United States, Level has a national PPO network of quality dental providers, representing a combination of direct contracts and leased networks. To confirm network status, navigate to the Account section, select Offices, and view the network status of each practicing provider.
- If you find that you are in-network | Submit claims directly to Level. The fee schedule applied will be identified on the explanation of benefits.
- If you find that you are out-of-network | Submit claims directly to Level as Level PPO offers out of network benefits. Should your office require payment upfront, be sure to provide them with an itemized statement of services to assist with maximum reimbursement. Document should also include the Tax ID, address and treating provider along with service lines and authorizations.
Exclusions
While Level’s dental plans are generous, they don’t cover everything. The following treatments are generally excluded from dental coverage:
- Teeth whitening
- Dental memberships
- In-office dental discount plans
- Medications
- Procedures that qualify for major medical health insurance coverage
- Oral health products
Policy
The following guidelines outline the coverage and eligibility criteria for Level dental plans
- Dependent Coverage: Coverage extends until the day before a dependent’s 26th birthday; permanently disabled dependents remain eligible beyond age 26.
- Plan Benefits: No missing tooth clause, waiting periods, or downgraded procedures.
- Claim Submission: Claims must be submitted within 180 days of the service date.
- Group Numbers: There are no group numbers for any Level plan. If your patient management system requires this field entry, please enter LEVEL or 00000
- Predeterminations: Not required but recommended for major services.
- Preventive & Diagnostic Services: Count towards the annual maximum
- Crowns: Paid on seat date
- Orthodontic payments: made as a lump sum or in installments up to the benefit maximum.
- Check Coverage: Only offered on Provider Dashboard
You can use Level’s Provider Dashboard to check a member’s plan guidelines before an appointment. If you don’t have a dashboard account, be sure to create an account to secure coverage prior to rendering service.
Orthodontic Care
Most of Level’s plans include coverage for orthodontic treatment in a shared annual maximum. For these plans, both dental and orthodontic care are covered in full (100%), up to that maximum. These members can apply additional benefits toward ongoing treatment when their annual maximum renews.
For some of our plans, orthodontic treatment is included as a separate lifetime maximum, with coinsurance. Some plans provide no orthodontic coverage. For all plans with orthodontic coverage, Invisalign and other clear aligner therapies are covered. We cover new orthodontic cases and orthodontics in progress.
- For a claim initiating orthodontic treatment (D8080/D8090), make sure to include the banding date, length of treatment, and total cost of treatment.
- Work in progress claims (D8670) should include the banding date, length of treatment, total cost of treatment, and an explanation of benefits from the previous carrier.
Emergency Care Outside the U.S.
For emergent or urgent care abroad, out-of-network services are covered at 100% of the billed amount, subject to deductible and annual maximum. Coverage applies only for services meeting emergent or urgent criteria.
- Emergent dental needs are potentially life threatening. They require immediate treatment to stop ongoing tissue bleeding, alleviate severe pain or infection, or address other serious conditions.
- Urgent dental needs require immediate attention to relieve pain or risk of infection.
Coverage for services that are deemed to constitute emergent or urgent diagnosis or treatment will be covered at 100% of the billed amount, subject to the members annual benefit maximum. Be sure to provide your patient with an itemized receipt or billing statement with the following information:
- Out-of-pocket expense in original currency. The amount will be converted by Level when we process your claim.
- Date of service
- List of services provided
- Name and address of the provider or retailer
- Phone number and email address of the provider, if applicable
- A narrative explaining the reason for the procedure performed If possible, the receipt or statement should be translated into English.