As the landscape of health and dental insurance changes due to the impact of the Affordable Care Act, Healthplex provides the support and knowledge to help guide our members and groups to making the best decisions. As the new laws are defined and updated, we will continue to be at the forefront so that our plans are compliant with all federal and state regulations.

For Adults/Families:

Oral care is an essential component of good overall health. Although dental benefits for adults are not mandated by the Affordable Care Act (ACA), we believe that adult dental care is important. For this reason, we offer ACA Compliant plans that provide comprehensive coverage at an affordable price.

For Children:

The Affordable Care Act (ACA) mandates that all families have dental coverage for their children up to age 19. By choosing a pediatric dental plan offered by us, you will get a plan that features affordable comprehensive coverage and no out-of-pocket costs other than a small office visit fee or deductible.

We strongly believe in the "Preventive Incentive" - regular visits for preventive and diagnostic care can minimize expensive major dental procedures later on. Our plans make this preventive care affordable, helping you save money while providing your child with excellent oral care.

Click on the links below to view our OFF Exchange(ACA Compliant) Dental Plans.

Dentcare Junior

Child(ren) up to age 19. Premiums are based on geographic region.
Co-payment Deductible Region Monthly Premium per Child Plan Information
$48 per visit. There are no copayments (or additional payments) required after the $336 annual maximum out-of-pocket is met. None Albany $18.95

Buffalo $14.45
Mid-Hudson $14.45
Rochester $14.45
Syracuse $14.45
Utica $14.45
$36 per visit. There are no copayments (or additional payments) required after the $252 annual maximum out-of-pocket is met. None NYC $11.15

Long Island $11.15
Click here to locate a provider in your area.

Dentcare Individual Adult or Family

Premiums are based on geographic region.
Co-payment Deductible Region Monthly Premium Plan Information
Individual Adult Individual + Spouse 1 Parent + Children Family
$48 per visit. There are no copayments (or additional payments) required after the $336 (individual) or $700 (family - covered pediatric services only) annual maximum out-of-pocket is met. None Albany $19.25 $38.50 $49.57 $68.82

Buffalo $19.50 $39.00 $42.62 $62.12
Mid-Hudson $19.50 $39.00 $42.62 $62.12
Rochester $19.25 $38.50 $42.37 $61.62
Syracuse $19.25 $38.50 $42.37 $61.62
Utica $19.25 $38.50 $42.37 $61.62
$36 per visit. There are no copayments (or additional payments) required after the $252 (individual) or $700 (family - covered pediatric services only) annual maximum out-of-pocket is met. None NYC $11.00 $22.00 $28.84 $39.84

Long Island $11.00 $22.00 $28.84 $39.84
Click here to locate a provider in your area.

Healthplex Young Smiles

Child(ren) up to age 19. Premiums are based on geographic region.
Co-payment Deductible Region Monthly Premium per Child Plan Information
None $75 annual Albany $18.95

Buffalo $14.45
Mid-Hudson $14.45
Rochester $14.45
Syracuse $14.45
Utica $14.45
None $75 annual NYC $11.15

Long Island $11.15
Click here to locate a provider in your area.

Healthplex Individual Adult or Family Smiles

Premiums are based on geographic region.
Co-payment Deductible Region Monthly Premium Plan Information
Individual Adult Individual + Spouse 1 Parent + Children Family
$48 per visit. There are no copayments (or additional payments) required after the $336 (individual) or $700 (family - covered pediatric services only) annual maximum out-of-pocket is met. None Albany $19.25 $38.50 $49.57 $68.82

Buffalo $19.50 $39.00 $42.62 $62.12
Mid-Hudson $19.50 $39.00 $42.62 $62.12
Rochester $19.25 $38.50 $42.37 $61.62
Syracuse $19.25 $38.50 $42.37 $61.62
Utica $19.25 $38.50 $42.37 $61.62
$36 per visit. There are no copayments (or additional payments) required after the $252 (individual) or $700 (family - covered pediatric services only) annual maximum out-of-pocket is met. None NYC $11.00 $22.00 $28.84 $39.84

Long Island $11.00 $22.00 $28.84 $39.84
Click here to locate a provider in your area.

To view our ON Exchange Plans please visit nystateofhealth.ny.gov

Contact our sales Department at 800-468-0466 or sales@healthplex.com