DENCAP Dental Plans, Inc offers this marketplace health insurance plan (Plan ID 31256MI0020018) so you can compare premiums, coverage levels, and provider access against other health plan insurance options. Use the modules below to decide whether this is the best health insurance plan for your household or if another insurance health plan fits better.
Marketplace enrollment for 2026 coverage typically runs Nov 1 – Jan 15 (dates may vary slightly in Michigan). Submit changes before the deadline to avoid a coverage gap.
Enroll by Dec 15 for Jan 1 starts.
Finalize plan switches before the window closes.
Special Enrollment Periods
You can change plans mid-year if you experience a qualifying life event (move, childbirth, marriage, loss of other coverage).
Report the event within 60 days.
Keep documentation handy for Healthcare.gov or your state exchange.
CSR & subsidy reminders
Premium tax credits and cost-sharing reductions (CSR) update annually when you re-submit your marketplace application.
Enter accurate income to maximize Advanced Premium Tax Credits.
Standard High Off Exchange Plan plans like this one keep deductibles and copays lower if you qualify.
Thinking about switching?
Before you leave your current plan, compare networks, drug coverage, and total cost using the cards on this page.
Match provider networks so ongoing care isn’t disrupted.
Confirm prescriptions stay on-formulary or budget for tier changes.
Track the official identifiers, documents, and filing dates tied to this plan. Open the marketing or formulary links whenever you need the latest PDF from the issuer.
Review the network branding plus the number of in-network clinicians we track from issuer filings. Counts update with each CMS import (Tue, 02 Dec 2025 06:13 GMT).
All providers in MichiganN/A
PCPs in MichiganN/A
Telehealth supportData pending
Nationwide providersN/A
N/A doctors statewideN/A PCPsN/A OB/GYN
Provider network(s)
['MIN002']
Providers
Michigan
All US states
All
N/A
N/A
PCP
N/A
N/A
Allergy
N/A
N/A
OB/GYN
N/A
N/A
Dentists
N/A
N/A
Drug coverage overview
0 drugs tracked
Inspect tier distribution plus authorization, step therapy, and quantity-limit counts sourced from HealthPorta’s formulary import.
Prior authorization
Drugs
Required
0
Not Required
0
Step therapy
Drugs
Required
0
Not Required
0
Quantity limits
Drugs
Has Limit
0
No Limit
0
Customer highlights
What stands out for members
Issuer: DENCAP Dental Plans, Inc · Plan ID 31256MI0020018 · 2026 filing.
Variant 31256MI0020018-00 (Standard Off Exchange Plan) currently displayed.
Use the cards on this page to explore network stats, drug coverage, and cost-sharing details.
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Benefits
Covered services & limitations
Pregnancy & family
Maternity, newborn, pediatric dental and vision extras.
Basic Dental Care - Child
20.00% Coinsurance after deductible
Tier 1 in-network20.00% Coinsurance after deductible
Out-of-network20.00% Coinsurance after deductible
Basic Dental Care - Child (Non EHB)
20.00% Coinsurance after deductible
Tier 1 in-network20.00% Coinsurance after deductible
Out-of-network20.00% Coinsurance after deductible
Limit: 1250.0 Dollars per Year
See Benefit Summary for Details and Exclusions
Major Dental Care - Child
50.00% Coinsurance after deductible
Tier 1 in-network50.00% Coinsurance after deductible
Out-of-network50.00% Coinsurance after deductible
Major Dental Care - Child (Non EHB)
50.00% Coinsurance after deductible
Tier 1 in-network50.00% Coinsurance after deductible
Tier 1 in-network50.00% Coinsurance after deductible
Out-of-network50.00% Coinsurance after deductible
Limit: 1250.0 Dollars per Year
See Benefit Summary for Details and Exclusions
Basic Dental Care - Adult
20.00% Coinsurance after deductible
Tier 1 in-network20.00% Coinsurance after deductible
Out-of-network20.00% Coinsurance after deductible
Limit: 1250.0 Dollars per Year
See Benefit Summary for Details and Exclusions
Dental Check-Up for Children
No Charge
Tier 1 in-networkNo Charge
Out-of-networkNo Charge
Limit: 2.0 Visit(s) per Year
Major Dental Care - Adult
50.00% Coinsurance after deductible
Tier 1 in-network50.00% Coinsurance after deductible
Out-of-network50.00% Coinsurance after deductible
Limit: 1250.0 Dollars per Year
See Benefit Summary for Details and Exclusions
Orthodontia - Adult
50.00% Coinsurance after deductible
Tier 1 in-network50.00% Coinsurance after deductible
Out-of-network50.00% Coinsurance after deductible
Limit: 1000.0 Dollars per Lifetime
See Benefit Summary for Details and Exclusions
Orthodontia - Child
50.00% Coinsurance after deductible
Tier 1 in-network50.00% Coinsurance after deductible
Out-of-network50.00% Coinsurance after deductible
Limit: 1000.0 Dollars per Lifetime
See Benefit Summary for Details and Exclusions
Routine Dental Services (Adult)
No Charge
Tier 1 in-networkNo Charge
Out-of-networkNo Charge
Limit: 3.0 Visit(s) per Year
See Benefit Summary for Details and Exclusions
Variant attributes
Community 1250 · Variant 31256MI0020018-00
Plan identifiers & tier
Issuer-provided metadata for this variant.
Business Year
2026
CSR Variation Type
Standard High Off Exchange Plan
HIOS Product ID
31256MI002
Metal Level
High
Plan ID (Standard Component ID with Variant)
31256MI0020018-00
Plan Marketing Name
Community 1250
Plan Variant Marketing Name
Community 1250
Issuer & service area
Issuer-provided metadata for this variant.
Issuer ID
31256
Issuer Marketplace Marketing Name
DENCAP Dental Plans, Inc
Market Coverage
SHOP (Small Group)
Multiple In Network Tiers
No
National Network
Yes
Network ID
MIN002
Out of Country Coverage
No
Out of Service Area Coverage
Yes
Out of Service Area Coverage Description
In-Network Dentists outside of Service Area
Service Area ID
MIS003
State Code
MI
Cost sharing & actuarial values
Issuer-provided metadata for this variant.
Begin Primary Care Deductible Coinsurance After Number Of Copays
0
Inpatient Copayment Maximum Days
0
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family Per Group
per group not applicable
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family Per Person
per person not applicable
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out
Not Applicable
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Group
$900 per group
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Person
$450 per person
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Individual
$450
Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Family Per Group
per group not applicable
Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Family Per Person
per person not applicable
Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Individual
Not Applicable
Additional attributes
Issuer-provided metadata for this variant.
Begin Primary Care Cost-Sharing After Number Of Visits
0
Child-Only Offering
Allows Adult and Child-Only
Composite Rating Offered
No
Dental Only Plan
Yes
First Tier Utilization
100%
Import Date
10/28/2025
Guaranteed Rate
Guaranteed Rate
New/Existing Plan
Existing
Medical EHB Deductible, Combined In/Out of Network, Family Per Group
$100 per group
Medical EHB Deductible, Combined In/Out of Network, Family Per Person
$50 per person
Medical EHB Deductible, Combined In/Out of Network, Individual
$50
Medical EHB Deductible, In Network (Tier 1), Family Per Group
$100 per group
Medical EHB Deductible, In Network (Tier 1), Family Per Person
$50 per person
Medical EHB Deductible, In Network (Tier 1), Individual
$50
Medical EHB Deductible, Out of Network, Family Per Group
$100 per group
Medical EHB Deductible, Out of Network, Family Per Person
$50 per person
Medical EHB Deductible, Out of Network, Individual
$50
Plan Effective Date
1/1/2026
Plan Expiration Date
12/31/2026
Plan Type
POS
QHP/Non QHP
Off the Exchange
Source Name
SERFF
Plan ID
31256MI0020018
Copay & coinsurance
Pharmacy cost sharing by tier
Drug tier
Pharmacy type
Copay amount
Copay option
Coinsurance rate
Coinsurance option
Mail order
Questions & answers
Frequently asked questions
How do I choose the right ACA plan in Michigan?
Community 1250 (31256MI0020018) is a High POS from DENCAP Dental Plans, Inc in Michigan for the 2026 coverage year.
Compare it against other options with the HealthPorta plan finder to confirm premiums, deductibles, and network access fit your household.
Does Community 1250 support telehealth or virtual urgent care?
The issuer has not published telehealth details yet. Review the Summary of Benefits and Coverage to confirm if virtual visits are included.
Is Community 1250 HSA-eligible and does it include dental or vision coverage?
HSA eligibility is not published; check the Summary of Benefits or ask the issuer.
Dental add-ons: Adult, Child.
Vision coverage is not listed for this plan.
Does Community 1250 support mail-order prescriptions?
Mail order coverage is not listed for this plan, so confirm with the issuer before relying on home delivery.
Is there out-of-country coverage for Community 1250?
No, out-of-country services are not covered for this plan.
Does Community 1250 cover care outside the service area?
Yes, you have limited out-of-area coverage. See the plan documents for referral and prior authorization rules. Details: In-Network Dentists outside of Service Area
How do I enroll in or manage payments for Community 1250?
Use HealthPorta to shortlist plans, then finish enrollment through Healthcare.gov or your state-based marketplace.
Disclaimer: Based on the Tue, 02 Dec 2025 06:13 GMT HealthPorta import from CMS issuer filings. Data is best-effort and should be validated with the issuer directly. Sources: CMS.gov and the HealthPorta Healthcare MRF API.
