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
Filings are limited to replacement once every 2 years. Waiting periods may apply. See detailed information in your benefits summary.
Exclusions: nan
Dental Check-Up for Children
No Charge
Tier 1 in-network
No Charge
Out-of-network
50.00%
Limit: 2.0 Exam(s) per Year
Limit of 2 cleanings and 2 exams per year.
Exclusions: nan
Major Dental Care - Adult
Coverage details pending
Orthodontia - Child
50.00%
Tier 1 in-network
50.00%
Out-of-network
75.00% Coinsurance after deductible
Limited to Medically Necessary Orthodontia. See detailed information in your benefits summary.
Exclusions: nan
Routine Dental Services (Adult)
No Charge
Tier 1 in-network
No Charge
Out-of-network
50.00%
Limit: 2.0 Exam(s) per Year
Limit of 2 cleanings and 2 exams per year.
Exclusions: nan