FLEX DHMO DENTAL NO DEDUCTIBLE; coverage for adults and children; free exam and fluoride; large network of providers · 31256MI0010006
DENCAP Dental Plans, Inc offers this marketplace health insurance plan (Plan ID 31256MI0010006) 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 Michigan). Submit changes before the deadline to avoid a coverage gap.
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Special Enrollment Periods
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Standard High Off Exchange Plan plans like this one keep deductibles and copays lower if you qualify.
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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).
Variant 31256MI0010006-00 (Standard Off Exchange Plan) currently displayed.
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Benefits
Covered services & limitations
Pregnancy & family
Maternity, newborn, pediatric dental and vision extras.
Basic Dental Care - Child
$20.00, 30.00%
Tier 1 in-network$20.00, 30.00%
Out-of-network100.00%
nan
Exclusions: nan
Basic Dental Care - Child (Non EHB)
$20.00, 30.00%
Tier 1 in-network$20.00, 30.00%
Out-of-network100.00%
Limit: 1200.0 Dollars per Year
$1200 Primary Care (General Dentist) Maximum. Maximums and waiting periods are waived for EHB benefits. Percentages are approximate. Your out of pocket (co-pay) payment to your Dentist is shown on the Schedule of Benefits. Click "Plan Brochure" above, then scroll to find the Schedule of Benefits for complete listing of covered services with co-pays.
Exclusions: nan
Major Dental Care - Child
$20.00, 40.00%
Tier 1 in-network$20.00, 40.00%
Out-of-network100.00%
nan
Exclusions: nan
Major Dental Care - Child (Non EHB)
$20.00, 40.00%
Tier 1 in-network$20.00, 40.00%
Out-of-network100.00%
Limit: 1200.0 Dollars per Year
$1200 Primary Care (General Dentist) Maximum. Maximums and waiting periods are waived for EHB benefits.s. Percentages are approximate. There is a 6-month waiting period for Class III benefits. Your out of pocket (co-pay) payment to your Dentist is shown on the Schedule of Benefits. Click "Plan Brochure" above, then scroll to find the Schedule of Benefits for complete listing of covered services with co-pays.
When 50 or more miles away from your selected General Dentist, DENCAP will reimburse 50% up to $100 for emergency services that relieve severe pain and are covered benefits. Click "Plan Brochure" above, then scroll to find the Schedule of Benefits for complete listing of covered services with co-pays.
Exclusions: nan
Basic Dental Care - Adult
$20.00, 30.00%
Tier 1 in-network$20.00, 30.00%
Out-of-network100.00%
Limit: 1200.0 Dollars per Year
$1200 Primary Care (General Dentist) Maximum. Percentages are approximate. Your out of pocket (co-pay) payment to your Dentist is shown on the Schedule of Benefits. Click "Plan Brochure" above, then scroll to find the Schedule of Benefits for complete listing of covered services with co-pays.
Exclusions: nan
Dental Check-Up for Children
$20.00, No Charge
Tier 1 in-network$20.00, No Charge
Out-of-network100.00%
Limit: 3.0 Visit(s) per Year
nan
Exclusions: nan
Major Dental Care - Adult
$20.00, 40.00%
Tier 1 in-network$20.00, 40.00%
Out-of-network100.00%
Limit: 1200.0 Dollars per Year
$1200 Primary Care (General Dentist) Maximum. Percentages are approximate. There is a 6-month waiting period for Class III benefits. Your out of pocket (co-pay) payment to your Dentist is shown on the Schedule of Benefits. Click "Plan Brochure" above, then scroll to find the Schedule of Benefits for complete listing of covered services with co-pays.
Exclusions: nan
Orthodontia - Adult
65.00%
Tier 1 in-network65.00%
Out-of-network100.00%
Limit: 1.0 Treatment(s) per Lifetime
In-Network Orthodontists give an $1200 discount with referral from your General Dentist.
Exclusions: nan
Orthodontia - Child
65.00%
Tier 1 in-network65.00%
Out-of-network100.00%
Limit: 1.0 Treatment(s) per Lifetime
In-Network Orthodontists give an $1800 discount with referral from your General Dentist.
Exclusions: nan
Routine Dental Services (Adult)
$20.00, No Charge
Tier 1 in-network$20.00, No Charge
Out-of-network100.00%
Limit: 2.0 Visit(s) per Year
Percentages are approximate. Your out of pocket (co-pay) payment to your Dentist is shown on the Schedule of Benefits. Click "Plan Brochure" above, then scroll to find the Schedule of Benefits for a complete listing of covered services with co-pays.
Exclusions: nan
Variant attributes
FLEX DHMO DENTAL NO DEDUCTIBLE; coverage for adults and children; free exam and fluoride; large network of providers · Variant 31256MI0010006-00
Plan identifiers & tier
Issuer-provided metadata for this variant.
Business Year
2025
CSR Variation Type
Standard High Off Exchange Plan
HIOS Product ID
31256MI001
Metal Level
High
Plan ID (Standard Component ID with Variant)
31256MI0010006-00
Plan Marketing Name
FLEX DHMO DENTAL NO DEDUCTIBLE; coverage for adults and children; free exam and fluoride; large network of providers
Plan Variant Marketing Name
FLEX DHMO DENTAL NO DEDUCTIBLE; coverage for adults and children; free exam and fluoride; large network of providers
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
0.46
First Tier Utilization
100%
Import Date
2024-09-09 20:01:26
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
per person not applicable
Medical EHB Deductible, Combined In/Out of Network, Individual
Not Applicable
Medical EHB Deductible, In Network (Tier 1), Family Per Group
$0 per group
Medical EHB Deductible, In Network (Tier 1), Family Per Person
$0 per person
Medical EHB Deductible, In Network (Tier 1), Individual
$0
Medical EHB Deductible, Out of Network, Family Per Group
per group not applicable
Medical EHB Deductible, Out of Network, Family Per Person
per person not applicable
Medical EHB Deductible, Out of Network, Individual
Not Applicable
Plan Effective Date
2025-01-01
Plan Expiration Date
2025-12-31
Plan Type
HMO
QHP/Non QHP
Both
Source Name
SERFF
Plan ID
31256MI0010006
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?
FLEX DHMO DENTAL NO DEDUCTIBLE; coverage for adults and children; free exam and fluoride; large network of providers (31256MI0010006) is a High HMO from DENCAP Dental Plans, Inc in Michigan 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 FLEX DHMO DENTAL NO DEDUCTIBLE; coverage for adults and children; free exam and fluoride; large network of providers 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 FLEX DHMO DENTAL NO DEDUCTIBLE; coverage for adults and children; free exam and fluoride; large network of providers 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 FLEX DHMO DENTAL NO DEDUCTIBLE; coverage for adults and children; free exam and fluoride; large network of providers 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 FLEX DHMO DENTAL NO DEDUCTIBLE; coverage for adults and children; free exam and fluoride; large network of providers?
No, out-of-country services are not covered for this plan.
Does FLEX DHMO DENTAL NO DEDUCTIBLE; coverage for adults and children; free exam and fluoride; large network of providers 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 Dentstis outside of Service Area
How do I enroll in or manage payments for FLEX DHMO DENTAL NO DEDUCTIBLE; coverage for adults and children; free exam and fluoride; large network of providers?
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.
