DENCAP Dental Plans, Inc offers this marketplace health insurance plan (Plan ID 31256MI0010007) 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 On 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).
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 31256MI0010007 · 2026 filing.
Variant 31256MI0010007-01 (Standard On Exchange Plan) currently displayed.
Use the cards on this page to explore network stats, drug coverage, and cost-sharing details.
Advertisement
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%
Basic Dental Care - Child (Non EHB)
$20.00, 30.00%
Tier 1 in-network$20.00, 30.00%
Out-of-network100.00%
Limit: 1800.0 Dollars per Year
Receive up to $1,500 a year per member for general dental care immediately, and up to $300 a year per member for specialist care after 12 months. Waiting periods and maximums do not apply to Essential Health Benefits (EHB). Percentages are approximate. Click "Plan Brochure" above, then scroll to find the Schedule of Benefits for complete listing of covered services with co-pays.
Major Dental Care - Child
$20.00, 40.00%
Tier 1 in-network$20.00, 40.00%
Out-of-network100.00%
Major Dental Care - Child (Non EHB)
$20.00, 40.00%
Tier 1 in-network$20.00, 40.00%
Out-of-network100.00%
Limit: 1800.0 Dollars per Year
Receive up to $1,500 a year per member for general dental care immediately, and up to $300 a year per member for specialist care after 12 months. Waiting periods and maximums do not apply to Essential Health Benefits (EHB). Percentages are approximate. Click "Plan Brochure" above, then scroll to find the Schedule of Benefits for complete listing of covered services with co-pays.
If you are 50 miles or more from your general dentist, DENCAP will reimburse 50% up to $100, for emergency care that treats serious pain and is a covered service.To see all covered services and co-pays, click "Plan Brochure" and scroll to the Schedule of Benefits.
Basic Dental Care - Adult
$20.00, 30.00%
Tier 1 in-network$20.00, 30.00%
Out-of-network100.00%
Limit: 1800.0 Dollars per Year
Receive up to $1,500 a year per member for general dental care immediately, and up to $300 per member for specialist care after 12 months. Percentages are approximate. Click "Plan Brochure" above, then scroll to find the Schedule of Benefits for a complete listing of covered services and co-payments.
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
Major Dental Care - Adult
$20.00, 40.00%
Tier 1 in-network$20.00, 40.00%
Out-of-network100.00%
Limit: 1800.0 Dollars per Year
Receive up to $1,500 a year per member for general dental care immediately, and up to $300 a year per member for specialist care after 12 months. There is a 6 month waiting period for Class III Benefits. Percentages are approximate. Click "Plan Brochure" above, then scroll to find the Schedule of Benefits for a complete listing of covered services and co-payments.
Orthodontia - Adult
80.00%
Tier 1 in-network80.00%
Out-of-network100.00%
Limit: 1.0 Treatment(s) per Lifetime
In-Network Orthodontists give a $1200 benefit with referral from your General Dentist.
Orthodontia - Child
70.00%
Tier 1 in-network70.00%
Out-of-network100.00%
Limit: 1.0 Treatment(s) per Lifetime
In-Network Orthodontists give your child(ren) an $1800 benefit with a referral from your General Dentist.
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
The percentages shown are approximate.Your out-of-pocket cost (called a co-pay) is listed in the Schedule of Benefits.To see all the covered services and co-pays, click "Plan Brochure" above, then scroll to the Schedule of Benefits.
Variant attributes
Flex Plus Enhanced · Variant 31256MI0010007-01
Plan identifiers & tier
Issuer-provided metadata for this variant.
Business Year
2026
CSR Variation Type
Standard High On Exchange Plan
HIOS Product ID
31256MI001
Metal Level
High
Plan ID (Standard Component ID with Variant)
31256MI0010007-01
Plan Marketing Name
Flex Plus Enhanced
Plan Variant Marketing Name
Flex Plus Enhanced
Issuer & service area
Issuer-provided metadata for this variant.
Issuer ID
31256
Issuer Marketplace Marketing Name
DENCAP Dental Plans, Inc
Market Coverage
Individual
Multiple In Network Tiers
No
National Network
No
Network ID
MIN001
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
MIS001
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
EHB Apportionment for Pediatric Dental
0.46
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
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
per group not applicable
Medical EHB Deductible, In Network (Tier 1), Family Per Person
per person not applicable
Medical EHB Deductible, In Network (Tier 1), Individual
Not Applicable
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
1/1/2026
Plan Expiration Date
12/31/2026
Plan Type
HMO
QHP/Non QHP
Both
Source Name
SERFF
Plan ID
31256MI0010007
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 Plus Enhanced (31256MI0010007) is a High HMO 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 Flex Plus Enhanced 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 Plus Enhanced 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 Plus Enhanced 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 Plus Enhanced?
No, out-of-country services are not covered for this plan.
Does Flex Plus Enhanced 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 Flex Plus Enhanced?
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.
