Dental & Vision Insurance | Spirit Dental PPO Plans

No — Spirit Dental & Vision plans have no waiting periods for any covered services, including major procedures like crowns, root canals, and periodontal treatment. This is a significant advantage over most individual dental plans, which typically impose 6-12 month waiting periods for major services. Coverage begins the first of the month following enrollment, and you can use the plan immediately for cleanings, fillings, and restorative work. The no-waiting-period feature makes Spirit particularly valuable for applicants who need dental work done soon or who have been putting off procedures waiting for coverage.

Spirit Dental plans carry a one-time $100 lifetime deductible per covered person, not an annual deductible that resets each year. Once you pay $100 out of pocket on covered services, the deductible is satisfied for the rest of your life on that policy. This is considerably more favorable than typical dental plans that impose $50-$100 annual deductibles resetting January 1st. For a family plan, each covered member has their own $100 lifetime deductible. Preventive services (cleanings, exams, X-rays) are typically covered at 100% without deductible, so most people only encounter the deductible on restorative or major work.

Yes, you can see any licensed dentist — Spirit plans work both in-network and out-of-network. In-network dentists (part of the Ameritas Dental Network) accept negotiated fees, giving you 25-50% savings compared to list prices. Out-of-network dentists can bill their usual rates, and you may be responsible for the difference between Spirit’s allowed amount and what the dentist charges. Most major urban and suburban areas have extensive Ameritas Network coverage. Before any significant work with an out-of-network provider, request a pre-treatment estimate so you know the exact out-of-pocket amount.

Most individual dental plans including Spirit organize coverage into three tiers: preventive care (cleanings, exams, X-rays, fluoride) at 100% typically with no deductible and no waiting period; basic restorative (fillings, simple extractions, oral surgery) at 70-80% coverage; and major restorative (crowns, bridges, dentures, root canals, periodontal treatment) at 50% coverage. Orthodontia is typically a separate rider or not covered on individual plans. Annual maximums on most plans range from $1,000-$3,000 per covered person per year. Cosmetic procedures (whitening, veneers purely for appearance) are generally not covered by any dental insurance.

Yes. Spirit Vision plans provide an annual allowance for a frame (typically $130-$200) plus a copay, OR an allowance for contact lenses in place of glasses (you choose one per benefit period). Lenses are covered annually with a copay structure — single vision, bifocal, progressive, and specialty lenses each have different copays. Eye exams are covered annually at low copay (typically $10-$20) with in-network providers. Vision plans are generally more straightforward than dental because the products (lenses, frames, contacts) are standardized. Specialty lens features like anti-reflective coating or photochromic (transition) lenses typically carry additional copays ranging $30-$75.