With the Dental Option, you have coverage for basic preventive services such as teeth cleaning and X-rays, and comprehensive services such as fillings and oral surgery.
The Dental Option you are enrolled in is based on your zip code. The Out-of-Area Plan is available to those without access to at least 2 dentists within 10 miles of their home ZIP code.
Review the dental coverages in the table below:
|
Dental Option |
Out-of-area* Dental Option |
| Network |
Non-network |
| Annual deductible |
$50 individual
$100 family |
$150 individual
$300 family |
$50 individual
$100 family |
| Annual maximum |
$2,000 per person |
| Preventive |
Covered at 100% |
Covered at 80% |
Covered at 100% up to plan limits |
| Basic services |
You pay 20%, after deductible |
You pay 50%, after deductible |
You pay 20%, after deductible up to plan limits |
| Major services |
You pay 50%, after deductible |
You pay 50%, after deductible |
You pay 50%, after deductible up to plan limits |
| Orthodontia |
Covered at 50% up to $2,000 lifetime maximum per person |
* Available to employees without access to at least 2 dentists within 10 miles of their home ZIP code.
Out of Area Zip Code List