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
Waiting period, deductible and annual maximum applies. See Schedule of Benefits.
Dental Check-Up for Children
30.00%
Tier 1 in-network
30.00%
Out-of-network
30.00%
Limit: 2.0 Procedure(s) per Benefit Period
Routine cleaning, exams, x-rays and fluoride. Sealants once every five years.
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%
Tier 1 in-network
50.00%
Out-of-network
50.00%
Waiting period and lifetime maximum applies. See Schedule of Benefits.
Routine Dental Services (Adult)
No Charge after deductible
Tier 1 in-network
No Charge after deductible
Out-of-network
No Charge after deductible
Deductible and annual maximum applies.