Plan Feature
ENHANCED
Dental Option
BASIC
Dental Option
Annual deductible
$25/person
None
Lifetime deductible
None
$50/person
Annual maximum benefit
$2,000
(not including orthodontia)
$1,500
Diagnostic/preventive services
 | Exams | |
| Cleaning (including periodontal cleaning) | |
| Application of fluoride | |
| X-rays | |
| Space maintainers |
100% of R&C*
(deductible does not apply)
80% R&C * after deductible
Basic restorative services
| Fillings | |
| Surgery | |
| Endodontics | |
| Periodontal procedures such as bone and gum (gingival) surgery |
80% R&C * after deductible
80% R&C * after deductible
Major restorative services
| Onlays | |
| Crowns | |
| Bridges |
50% R&C * after deductible
50% R&C * after deductible
Orthodontia
and treatment of Bruxism
50% R&C * up to $1,000 lifetime maximum
(deductible does not apply)
Not covered
Emergency treatment
Same as any other covered expense
Same as any other covered expense