Results for Dental
What's Covered Under the Basic Option
With the Basic dental option, you get coverage for preventive and basic care, including sealants, bitewing X-rays and full-mouth X-rays.
You might consider the Basic option if you and your dependents do not anticipate needing much dental care, aside from preventive and basic care.
| Basic Option | |
|---|---|
| Your Deductible | You You + one or You + family |
| The Plan Pays: Preventive Care | Plan pays 100% Includes exams, cleanings, sealants, X-rays |
| Major Care | Not covered |
| Orthodontia | Not covered |
| Temporomandibular Joint Dysfunction (TMJ) | Not covered |
| Annual Benefits Maximum | $1,500 |
Reasonable and Customary Charges: The plan pays up to reasonable and customary (R&C) charges for out of network care. You are responsible for any cost difference if your expenses are more than the R&C limits.
A Note About Dental Services
There may be limitations to some of these benefits, including, but not limited to, the number of cleanings and oral exams covered in a calendar year, and time limitations for filling and crown replacements. For more information on services, go to Your Benefits™.
