Dental Insurance

Dental Benefits

Premium Plan

Calendar Year Max.
 
Individual Deductible
 
Family Deductible
 
Dependent Coverage
 
 
 
Exams, Cleanings, Flouride
 
X-Rays
 
 
 
 
Sealants/Fillings/Root Canal
 
Space Maintainers/Biopsies
 
Minor Emergency/Extractions
 
Root Canals (Post/Anterior)
 
Denture Repair
 
Oral Surgery/Anesthesia
 
Crowns
 
Surgical Periodontics
 
 
 
Single
 
Family
$1,800
 
$0
 
$0
 
26
 
 
 
Covered at 100%
 
Covered at 100%
 
 
 
 
Covered at 100%
 
Covered at 100%
 
Covered at 100%
 
Covered at 100%
 
Covered at 100%
 
Covered at 100%
 
Covered at 80%
 
Covered at 50%
 
 
 
$57.00
 
$153.00

Diagnostics

Diagnostics

Major/Minor

Major/Minor

Monthly Rates

Monthly Rates