Dentegra Dental PPO Family Preferred Plan · 11339KS0010008
Dentegra Insurance Company offers this marketplace health insurance plan (Plan ID 11339KS0010008) 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 2025 coverage typically runs Nov 1 – Jan 15 (dates may vary slightly in Kansas). Submit changes before the deadline to avoid a coverage gap.
Enroll by Dec 15 for Jan 1 starts.
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Special Enrollment Periods
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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 On Exchange Plan plans like this one keep deductibles and copays lower if you qualify.
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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 KansasN/A
PCPs in KansasN/A
Telehealth supportData pending
Nationwide providersN/A
N/A doctors statewideN/A PCPsN/A OB/GYN
Provider network(s)
['KSN001']
Providers
Kansas
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: Dentegra Insurance Company · Plan ID 11339KS0010008 · 2025 filing.
Tier 1 in-network20.00% Coinsurance after deductible
Out-of-network30.00% Coinsurance after deductible
nan
Exclusions: nan
Dental Check-Up for Children
0.00%
Tier 1 in-network0.00%
Out-of-network0.00%
nan
Exclusions: nan
Major Dental Care - Adult
50.00% Coinsurance after deductible
Tier 1 in-network50.00% Coinsurance after deductible
Out-of-network60.00% Coinsurance after deductible
nan
Exclusions: nan
Orthodontia - Adult
Coverage details pending
nan
Exclusions: nan
Orthodontia - Child
50.00% Coinsurance after deductible
Tier 1 in-network50.00% Coinsurance after deductible
Out-of-network50.00% Coinsurance after deductible
Orthodontic services require prior authorization and are only covered for eligible children with cases of severe orthodontic abnormality caused by genetic deformity (such as cleft lip or cleft palate) or traumatic facial injury resulting in serious health impairment to the beneficiary at the present time.
Exclusions: nan
Routine Dental Services (Adult)
0.00%
Tier 1 in-network0.00%
Out-of-network10.00%
nan
Exclusions: nan
Variant attributes
Dentegra Dental PPO Family Preferred Plan · Variant 11339KS0010008-01
Plan identifiers & tier
Issuer-provided metadata for this variant.
Business Year
2025
CSR Variation Type
Standard High On Exchange Plan
HIOS Product ID
11339KS001
Metal Level
High
Plan ID (Standard Component ID with Variant)
11339KS0010008-01
Plan Marketing Name
Dentegra Dental PPO Family Preferred Plan
Plan Variant Marketing Name
Dentegra Dental PPO Family Preferred Plan
Issuer & service area
Issuer-provided metadata for this variant.
Issuer ID
11339
Issuer Marketplace Marketing Name
Dentegra Insurance Company
Market Coverage
Individual
Multiple In Network Tiers
No
National Network
Yes
Network ID
KSN001
Out of Country Coverage
No
Out of Service Area Coverage
Yes
Out of Service Area Coverage Description
Nationwide Network
Service Area ID
KSS001
State Code
KS
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
$850 per group
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Person
$425 per person
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Individual
$425
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
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
EHB Apportionment for Pediatric Dental
1.0
First Tier Utilization
100%
Import Date
2024-08-05 20:01:34
Guaranteed Rate
Guaranteed Rate
New/Existing Plan
Existing
Medical EHB Deductible, Combined In/Out of Network, Family Per Group
per group not applicable
Medical EHB Deductible, Combined In/Out of Network, Family Per Person
$60 per person
Medical EHB Deductible, Combined In/Out of Network, Individual
$60
Medical EHB Deductible, In Network (Tier 1), Family Per Group
per group not applicable
Medical EHB Deductible, In Network (Tier 1), Family Per Person
$60 per person
Medical EHB Deductible, In Network (Tier 1), Individual
$60
Medical EHB Deductible, Out of Network, Family Per Group
per group not applicable
Medical EHB Deductible, Out of Network, Family Per Person
$60 per person
Medical EHB Deductible, Out of Network, Individual
$60
Plan Effective Date
2025-01-01
Plan Expiration Date
2025-12-31
Plan Type
PPO
QHP/Non QHP
On the Exchange
Source Name
SERFF
Plan ID
11339KS0010008
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 Kansas?
Dentegra Dental PPO Family Preferred Plan (11339KS0010008) is a High PPO from Dentegra Insurance Company in Kansas for the 2025 coverage year.
Compare it against other options with the HealthPorta plan finder to confirm premiums, deductibles, and network access fit your household.
Does Dentegra Dental PPO Family Preferred Plan 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 Dentegra Dental PPO Family Preferred Plan 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 Dentegra Dental PPO Family Preferred Plan 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 Dentegra Dental PPO Family Preferred Plan?
No, out-of-country services are not covered for this plan.
Does Dentegra Dental PPO Family Preferred Plan 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: Nationwide Network
How do I enroll in or manage payments for Dentegra Dental PPO Family Preferred Plan?
Use the issuer portal https://apps.dentegra.com/hx/checkout to pay premiums or start enrollment, then return to HealthPorta for benefit comparisons.
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.
