Results for Dental

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What’s Covered Under the Comprehensive Option

With the Comprehensive dental option, you get coverage for preventive and basic care, including sealants, bitewing X-rays and full-mouth X-rays. Plus, you get coverage for major care, like bridges, crowns, inlays, onlays, dentures and implant once every seven years. In addition, you’re covered for TMJ and orthodontia.

You might consider the Comprehensive option if you or your dependents need orthodontia during the upcoming plan year.

 Comprehensive Option
Your Deductible

You
$50

You + one or You + family
$150

The Plan Pays: Preventive Care

Plan pays 100% Includes exams, cleanings, sealants, X-rays

Basic Care

Plan pays 80% after deductible
Includes extractions, fillings, root canals

Major Care

Plan pays 50% after deductible
Includes crowns, dentures, bridges

Orthodontia

50% up to the lifetime maximum of $1,250
For adults and children up to age 19

Temporomandibular Joint Dysfunction (TMJ)

50% up to the lifetime maximum of $1,000

Annual Benefits Maximum

$1,500 The most the plan pays per person

Reasonable and Customary Charges: A charge is considered “reasonable and customary” (R&C) if it matches the general cost of that service within your geographic area. If your health care provider charges above the reasonable and customary charge, you may have to pay the difference between the R&C charge and how much your provider charges.

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 EmployeeConnect > Your Benefit Resources > Health and Insurance > Summary Plan Descriptions.