DENTAL
$1,000
In dental benefits per calendar year.
$150 family deductible
$50 individual deductible
PLAN PAYS:
100% No deductible
Routine six-month preventive dental exams, including cleanings and annual routing X-rays
70% After deductible
Fillings
Routine tooth extractions
None routine X-rays
Emergency care to relieve pain
VISION
$150
In vision benefits
per calendar year.
No deductible
No waiting period.
30%
Yearly preventive vision exam- up to $50 per calendar year.
$100
Eyeglasses (lenses or frames) or contact lenses -up to $100 per calendar year.
$2,500
$100 deductible
per person.
80% After deductible
Repairs for:
50%
After deductible and any applicable waiting period
Dental implants subject to $2,000 lifetime maximum
Root canals
Dentures and bridges
Periodontal maintenance
Periodontal (deep) cleaning
Complex tooth extractions
$400
In vision benefits per calendar year.
No waiting period
90%
$300
PLUS:
Additional savings on vision-related purchases when visiting participating vision centers and professionals.
HEARING
$750
In hearing benefits per calendar year
UP TO $50 PER YEAR
UP TO $700 PER YEAR
UP TO 50% OFF
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