Dental coverage as simple, easy and affordable as you always wanted it to be.
Plan II features:
- No waiting periods on preventive care—Including immediate coverage for cleanings twice a year.
- Choose any dentist—In-Network or Out-of-Network, you can enjoy the same great coverage.
- Affordable—No deductible for preventive services, and a $1,000 annual maximum.
Benefit Highlights
Dental Services | In-Network / Out-of-Network Dentist | Waiting Periods |
Plan Pays | ||
Diagnostic and Preventive Services | ||
Diagnostic and Preventive Services* exams and cleanings twice a year, bitewing X-Rays, and fluoride treatments to age 14. | 50% | None |
Emergency Palliative Treatment* | 50% | None |
Radiographs / Diagnostic Imaging* X-rays | 50% | None |
Minor Services | ||
Periodontal Cleaning following active periodontal therapy | 50% | None |
Denture and Bridge Repairs and Relines | 50% | None |
Minor Restorative Services silver and white fillings | 50% | None |
Major Services | ||
Oral Surgery Services extraction and dental surgery, including local anesthesia, suturing, and post operative care | 50% | 12 months |
Endodontic Services Root canals | 50% | 12 months |
Periodontic Services Treatment for diseases of the gums and supporting structures of the teeth | 50% | 12 months |
Prosthodontic Services Bridges, dentures and implants | 50% | 12 months |
Crown and Cast Restorations Metal and porcelain crowns | 50% | 12 months |
TMD Treatment Treatment for jaw and facial joint disorders | 50% | 12 months |
Maximums and Deductible | ||
Policy Year Maximum | $1,000 per member | - |
TMD Lifetime Maximum | $300 per member | - |
Deductible (per policy year) *Deductible waived for these services | $50 per member | - |
Allowed Amounts | ||
Allowed Amounts-In-Network/Out-of-Network | PPO Fee/80th Percentile |