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Benefits

Dental Care

Overview

Benefit Coverage

Calendar Year Maximum – $3,000 (per family member

Reimbursement – 2023 O.D.A Fee Guide

Member Advantage Card – Dental Reimbursement

Coinsurance – 100%

  • Basic/Preventative:

    • Oral Exams/Light Scaling/Polishing – Up to once every 6 months per procedure
    • Scaling/Root Planing/Occlusal Equilibration – 8 units per calendar year for all procedures combined

Repairs/Relines/Rebases – Once every 24 months

Implants – $3,000 per family member per year (inclusive of all dental care services)

Orthodontics (Dependent Child Only) – 60% (under age of 21)

Orthodontics Lifetime Maximum – $2,500

 

Who is covered

Member, Spouse, Dependent Child

Related Forms

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We know that you may have questions or need assistance to find the information you are looking for. We’re here to offer answers and help in any way we can. Please don’t hestitate to Contact Us if you have questions about the following, or anything else.

Finding what you need on the
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Registering or updating your
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Downloading mobile apps and
using our web portal

Updating banking information for claims direct deposit (Electronic Funds Transfer)

Acquiring Member
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Submitting online claims forms