Preventive: This plan includes coverage for one exam per year. 100% preventive dental benefits, routine exams, cleanings, fluoride treatments, sealants, and more.
Basic: Maximum Covered Expenses (MCE): Filling restoration, extractions – surgical removal of teeth, and more.
Major: Maximum Covered Expenses (MCE): Onlays, maxillary partial denture – resin base, denture repair, endodontics – root canal, periodontal scaling, and root planing, crown and crown repairs, pontics, fixed bridges, and more. 6-month waiting period.
Claims for Preventive (Type 1) visits are paid based on the maximum amount a network provider may charge. If you visit an out-of-network dentist, claims are paid based on the lowest contracted network provider fee in your ZIP Code. Claims for Basic (Type 2) and Major (Type 3) services are paid based on a list of covered dental procedures showing the maximum dollar amount insurance will pay for each. You pay the difference between what the plan pays and the dentist’s actual charge. If you select a network provider, you may have lower out-of-pocket costs.