Benefits Vary By Plan

Varying by plan, dental benefits include: (1) Preventive and diagnostic services are covered in full, or with a $10 copay, such as: prophylaxis; oral evaluations; diagnostic evaluations; sealants; and X-rays. (2) Intermediate services and periodontal and endodontic services with enrollee cost obligations ranging from 20 to 45 percent, such as: restorative procedures such as fillings; prefabricated stainless steel crowns; periodontal scaling; routine extractions; and denture adjustments. (3) Major services including restorative dentistry and prosthetics, with enrollee cost obligations ranging from 50 to 65 percent, such as: root canals; periodontal services such as gingivectomy; major restorative services such as crowns, oral surgery, bridges; and prosthodontic services such as complete dentures. (4) Orthodontia, with enrollee cost obligations ranging from 50 to 70 percent, subject to up to a 24-month waiting period. Per-person deductibles range from $0 to $75. Varying by plan, vision benefits include: comprehensive vision services; discounts on laser vision correction; repair and replacement of frames or lenses for one year from date of delivery; coverage for elective and medically necessary contact lenses; prosthetic eye replacement; and eye health management programs.