Tier 1 in-network
0.00%
Out-of-network
0.00%
Please refer to Plan Brochure for detailed services covered, not covered, and frequency limitations.
Basic Dental Care - Adult
Coverage details pending
Issuer did not share extra notes for this benefit beyond the summary above.
Dental Check-Up for Children
0.00%
Tier 1 in-network
0.00%
Out-of-network
0.00%
Limit: 1.0 Visit(s) per 6 Months
Dental Check-up is limited to 1 per 6 consecutive month period. Please refer to Plan Brochure for detailed services covered, not covered, and frequency limitations.
Major Dental Care - Adult
Coverage details pending
Issuer did not share extra notes for this benefit beyond the summary above.
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
Medically necessary only. Please refer to Plan Brochure for detailed services covered, not covered, and frequency limitations.
Routine Dental Services (Adult)
Coverage details pending
Issuer did not share extra notes for this benefit beyond the summary above.