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*Careington Dental Cost as depicted here represents fees based on the the averaged national assigned Careington Care POS Series fee schedules.
**Any Dentist Cost as depicted here is based on the national averaged 80th percentile usual and customary rates as detailed in the FairHealth Report.
Prices subject to change.
Dental Coverage
Here are the benefits you receive:
2The 180-day waiting period applies in AK, AL, AR, AZ, CA, CO, CT,DC, DE, FL, GA, IA, ID, IL, IN, KY, LA,
MA, MD, ME, MI, MN, MO, MS, MT, NE, NC, ND, NJ, OH, OK, OR, PA, SC, SD, TN, TX, UT, VA, WI, WV and WY.
Limitations and Exclusions
This plan provides limited benefits for specified dental services and treatment. It's not a major medical
insurance plan and does not provide benefits for: Procedures before the effective date, after the
termination date of coverage, during a waiting period, or in excess of the maximum calendar year
benefit; preventive services performed within 150 days of previously submitted preventive services;
repairs to dental work within 180 days of the initial procedure; replacement prosthetics, crowns, inlays
or onlays within 5 years of the previous placement; dental implants or the removal of implants; cosmetic services, unless performed to correct a functional disorder; orthodontic treatment and services;
replacement of any tooth missing prior to the effective date; placement of full or partial dentures,
including Maryland Bridge, unless replacing a functioning natural tooth extracted while you were
covered; procedures performed by a person other than a Dentist or Dental Hygienist or by an insured's immediate family member. This provides a summary of benefits, limitations and exclusions. In certain
states, an outline of coverage is available from the agent or insurer. Please refer to the outline of
coverage for a description of the important features of the dental benefit plan. Please read the
coverage documents carefully for a complete listing of benefits, limitations and exclusions.
Here are the benefits you receive:
| Services | Benefit | ||
| Preventive Services Includes: cleanings, exams, x-rays, fluoride and sealants. Two visits per person each policy year, separated by at least 150 days |
$100/visit | ||
| Basic Services In the first policy year, payments are 50% of the per-service benefit. After the first year, payments are 100% of the per-service benefit. |
|||
| • Anesthesia | $70-$275/service | ||
| • Fillings | $90-$375/service | ||
| • Extractions | $80-$100/service | ||
| • Denture Adjustment and Repair | $55-$350/service | ||
| Major Services In certain states2 there is a 180-day waiting period on major services. After the waiting period, payments are 50% off per-service benefit for the remainder of the first policy year. After the first year, payments are 100% of the per-service benefit. |
|||
| • Anesthesia | $20-$375/service | ||
| • Crowns | $40-$450/service | ||
| • Endodontics | $30-$400/service | ||
| • Periodontics | $30-$325/service | ||
| • Dentures | $275-$400/service | ||
| • Fixed Prosthodontics | $175-$375/service | ||
| • Oral Surgery | $75-$1,000/service | ||
| Annual Maximum The maximum calendar-year benefit for Basic Services. Preventive Services benefits do not take away from Basic Services benefits. |
$1,500/year
for Basic Services |
||
2The 180-day waiting period applies in AK, AL, AR, AZ, CA, CO, CT,DC, DE, FL, GA, IA, ID, IL, IN, KY, LA,
MA, MD, ME, MI, MN, MO, MS, MT, NE, NC, ND, NJ, OH, OK, OR, PA, SC, SD, TN, TX, UT, VA, WI, WV and WY.
Limitations and Exclusions
This plan provides limited benefits for specified dental services and treatment. It's not a major medical
insurance plan and does not provide benefits for: Procedures before the effective date, after the
termination date of coverage, during a waiting period, or in excess of the maximum calendar year
benefit; preventive services performed within 150 days of previously submitted preventive services;
repairs to dental work within 180 days of the initial procedure; replacement prosthetics, crowns, inlays
or onlays within 5 years of the previous placement; dental implants or the removal of implants; cosmetic services, unless performed to correct a functional disorder; orthodontic treatment and services;
replacement of any tooth missing prior to the effective date; placement of full or partial dentures,
including Maryland Bridge, unless replacing a functioning natural tooth extracted while you were
covered; procedures performed by a person other than a Dentist or Dental Hygienist or by an insured's immediate family member. This provides a summary of benefits, limitations and exclusions. In certain
states, an outline of coverage is available from the agent or insurer. Please refer to the outline of
coverage for a description of the important features of the dental benefit plan. Please read the
coverage documents carefully for a complete listing of benefits, limitations and exclusions.
A simple, affordable
plan for good health
Dental Coverage pays cash benefits
that help you pay for dental checkups
and treatment.
plan for good health
Dental Coverage pays cash benefits
that help you pay for dental checkups
and treatment.
| • | No waiting periods for check-ups - you get $100 for a visit every six months |
| • | Get a set cash amount for each dental treatment such as extraction or a filling |
| • | Visit any dentist - no network restrictions |
| • | Receive cash benefits directly, or allow your dentist to submit the claim and receive the payment |
| • | In most states, apply for coverage through age 70 and renew up to age 75. (Apply through age 64 and renew up to age 70 in CO, MA, MD, MN, MS, NC, NJ, OH, OR, SD and UT.) |
