Accidental Dental
Coverage details pending
Refer to the Policy for the Dental Accident Benefit Maximum
Exclusions: nan
Basic Dental Care - Adult
50.00% Coinsurance after deductible
Tier 1 in-network
50.00% Coinsurance after deductible
Out-of-network
70.00% Coinsurance after deductible
Waiting periods vary based on the plan. See Policy for waiting periods.
Exclusions: nan
Dental Check-Up for Children
No Charge after deductible
Tier 1 in-network
No Charge after deductible
Out-of-network
No Charge after deductible
Limit: 2.0 Procedure(s) per Benefit Period
Routine cleaning, exams, x-rays and fluoride. Sealants once every five years.
Exclusions: nan
Major Dental Care - Adult
70.00% Coinsurance after deductible
Tier 1 in-network
70.00% Coinsurance after deductible
Out-of-network
100.00%
Waiting periods vary based on the plan. See Policy for waiting periods.
Exclusions: nan
Orthodontia - Child
50.00%
Tier 1 in-network
50.00%
Out-of-network
70.00%
Limit: 1.0 Treatment(s) per Lifetime
nan
Exclusions: nan
Routine Dental Services (Adult)
No Charge
Tier 1 in-network
No Charge
Out-of-network
30.00%
nan
Exclusions: nan