Step-up Preventive

A plan design that rewards healthy dental routines

Better oral health can lead to better overall health, helping your business and employees control your health care costs. When you offer a Dental PPO or Dental In-Network Only (INO) plan, apply our Step-up Preventive plan design to encourage and reward preventive care.

How it works (for illustrative purposes)

Example 1: When a dental member completes their preventive care requirements in year one, they'll “step up” to a higher coinsurance benefit in year two. If they do it again in year two, their benefit steps up again in year three.*

Year 1: 70% coinsurance for basic covered services.  Preventive care requirements are  completed. Basic coinsurance steps up.
Year 2: 80% coinsurance. Preventive care requirements are  completed. Coinsurance steps up again.
Year 3: 90% coinsurance. Coinsurance remains as preventive  requirements are met each year.

Example 2: Members who don’t meet the requirements the following year, will have their coinsurance benefit “step down" to the prior year's rate. Members who do not meet requirements will not see a change to their benefits.

Year 1: 70% coinsurance for basic covered services. Preventive care requirements are completed. Basic coinsurance steps up.
Year 2: 80% coinsurance.  Preventive care requirements are  not completed.
Year 3: 70% coinsurance. Coinsurance steps down.


Add happy to your wellness plan.

Not only can the Step-up Preventive plan design help lower costs and improve health, it can help keep your employees happy, too. Benefits are an important part of retention. This is a flexible way for employers to modernize their benefit package and improve their bottom line.

Add flexibility as another reason to try.

Customers can choose which benefits they want to "step up." We encourage covering preventive care services at 100% coinsurance to help encourage members to get their care.

  • Preventive & diagnostic 
  • Basic
  • Major & restorative 
  • Any combination of the above

Understanding the benefit increase. 

  • Coinsurance benefit increases will happen after each plan or calendar year that the member completes their preventive care requirements.
  • A customer can choose to not add the benefit increase to certain benefit categories. For example, a customer can choose to apply the increase to basic services but maintain preventive and diagnostic coverage at 100%.
  • The trigger for the benefit increases is through provider billing, which must include an American Dental Association (ADA) code in the preventive category range.

Benefit set-up options

Questions? We're here to help.

Contact your UnitedHealthcare representative or broker for more information.

* Plan benefits will have a floor and a ceiling, which means the coinsurance benefit will never go above the ceiling (e.g., 90%) or below the floor (e.g., 70%).