Stay in-network and save!

You can use any dentist you like but you will generally pay less if you choose an in-network provider.

Expecting extra dental work this year?

Consider contributing the maximum to your Health Savings Account (HSA). You can also contribute to a Limited Purpose Flexible Spending Account to save even more.

Services Basic Premium
Preventive care (two cleanings per year, check-up, and X-rays) You pay $0 You pay $0
Annual deductible $50 per person, no family limit $75 per person, $150 per family
Basic services (fillings, periodontics, root canals, simple and surgical extractions) You pay 50% after deductible You pay 20% after deductible
Major services (bridges, dentures, crowns, and oral surgery) You pay 50% after deductible You pay 50% after deductible
Maximum annual benefit for basic and major services Plan pays $1,000 per person Plan pays $2,000 per person
Orthodontia for children under age 19 Not covered You pay 50% after deductible
Lifetime maximum benefit for orthodontia N/A Plan pays $2,000
View orthodontia examples

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