Plan Coverage - In Network
|
Plan Types |
Coverage $48.73 |
Value $29.19 |
Budget $16.00 |
|---|---|---|---|
|
Company National |
Select |
Select |
Dental Basics & Discount Card |
|
In Network |
In Network |
In Network |
In Network |
|
Deductible- |
$50 |
Individual $50 |
No Deductible |
|
Family |
$150 |
Family $150 |
No Deductible |
|
Preventive |
You pay Zero |
You pay Zero |
Reimbursed up to $75 |
|
Basic Services |
Year 1 you pay 40% |
Year 1 You pay 40% |
Year 1 You |
|
2nd Year + |
Year 2 you pay 20% |
Year 2 you pay 20% |
Year 2 No Charge |
|
Major Services |
Year 1 you pay 75% |
Year 1 You Pay 85% |
With Network Savings Card |
|
2nd Year |
Year 2 you pay 50% |
Year 2 You Pay 75% |
Up to 45% off in Network |
|
Annual Max |
Year 1 Annual |
Year 1 Annual Max is $1,000 |
$500 |
|
2nd Year |
Year 2 Max $2,500 |
Year 2-1,500 Year 3-2,000 |
$500 |
|
Diagnostic |
You pay Zero for |
Not Applicable |
Reimburses up to $75 |
|
Othodonics |
Year 1 you pay 85% |
Not |
Not |
Plan Coverage - Out of Network
|
Types |
Coverage $48.73 |
Value $29.19 |
Budget $16.00 |
|---|---|---|---|
|
Company |
Select |
Select |
Dental Basics & Discount Card |
|
Out of Network |
Out of Network |
Out of Network |
Out of Network |
|
Deductible-Individual |
$100 |
Individual $100 |
No Deductible |
|
Family |
$300 |
Family $300 |
No Deductible |
|
Preventive Services |
You pay 30% |
You pay 30% |
Reimbursed up to $75 |
|
Basic Services |
Year 1 you pay 70% |
Year 1 You pay 70% |
Year 1 You pay 50% |
|
2nd Year + |
Year 2 you pay 50% |
Year 2 you pay 50% |
Year 2 No Charge |
|
Major Services |
Year 1 you pay 85% |
Year 1 You Pay 90% |
No Benefit |
|
2nd Year |
Year 2 you pay 75% |
Year 2 You Pay 85% |
No Benefit |
|
Annual Max |
Year 1 Annual |
Year 1 Annual Max is $1,000 |
$500 |
|
2nd Year |
Year 2 Max $2,500 |
Year 2- $1,500 |
$500 |
|
Diagnostic |
You pay 30% for |
You pay |
Reimburses up to $75 |
|
Othodonics |
Year 1 you pay 85% |
Not Applicable
|
Not Applicable
|
