Accidental Dental
Coverage details pending
Issuer did not share extra notes for this benefit beyond the summary above.
Basic Dental Care - Adult
50.00% Coinsurance after deductible
Tier 1 in-network
50.00% Coinsurance after deductible
Out-of-network
75.00% Coinsurance after deductible
6 Month Waiting Period, Covered up to a $750 annual benefit maximum (combined across all covered adult dental service categories)
Dental Check-Up for Children
No Charge after deductible
Tier 1 in-network
No Charge after deductible
Out-of-network
30.00% Coinsurance after deductible
Limit: 2.0 Visit(s) per Year
Major Dental Care - Adult
70.00% Coinsurance after deductible
Tier 1 in-network
70.00% Coinsurance after deductible
Out-of-network
85.00% Coinsurance after deductible
12 Month Waiting Period, Covered up to a $750 annual benefit maximum (combined across all covered adult dental service categories)
Orthodontia - Adult
Coverage details pending
Issuer did not share extra notes for this benefit beyond the summary above.
Orthodontia - Child
50.00% Coinsurance after deductible
Tier 1 in-network
50.00% Coinsurance after deductible
Out-of-network
50.00% Coinsurance after deductible
Dentally Necessary Coverage Only.
Routine Dental Services (Adult)
No Charge after deductible
Tier 1 in-network
No Charge after deductible
Out-of-network
50.00% Coinsurance after deductible
Covered up to a $750 annual benefit maximum (combined across all covered adult dental service categories)