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
50.00% Coinsurance after deductible
Dental Check-Up for Children
No Charge
Tier 1 in-network
No Charge
Out-of-network
No Charge
Limit: 2.0 Visit(s) per Year
Exclusions: Child age limited to 19
Major Dental Care - Adult
75.00% Coinsurance after deductible
Tier 1 in-network
75.00% Coinsurance after deductible
Out-of-network
75.00% Coinsurance after deductible
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
Only for the treatment of improper alignment of biting or chewing surfaces of upper and lower teeth through the installation of orthodontic appliances.
Exclusions: Child age limited to 19
Routine Dental Services (Adult)
No Charge
Tier 1 in-network
No Charge
Out-of-network
No Charge
Limit: 2.0 Visit(s) per Year