When it comes to maintaining overall health and wellbeing, taking care of your teeth is just as important as taking care of the rest of your body. Along with daily brushing and flossing, regular dental visits can greatly reduce the occurrences of major oral health issues.

To help you and your family stay healthy, we offer no-cost preventive care with all our dental options.

Coverage and costs overview

  Pediatric benefits
(Up to age 19)
In & out-of-network		 Adult benefits
(Age 19 and older)
In & out-of-network
Deductible

Per enrollee: $50
2/+ enrollees: $150
Applies to diagnostic & preventative, basic, major services and orthodontic services

Single: $50
Family: $150
Applies to diagnostic & preventative, basic and major services
Annual maximum
(per member)

None

$1,500
Applies diagnostic & preventive, basic and major services
Out-of-pocket maximum

Per enrollee: $450
2/+ enrollees: $900

None

Diagnostic & preventive services

e.g. cleanings and adult exams

0% coinsurance
including pediatric exams

0% coinsurance

Basic service

e.g. fillings, adult root canals

20% coinsurance

20% coinsurance

Major services

e.g. select crowns, dentures

50% coinsurance

50% coinsurance

Orthodontic services

e.g. medically necessary braces up to age 19

50% coinsurance

Not covered
Waiting periods

None

None

Note: Orthodontic services are not covered for members 19 and older.

Plan information and documents

Find a dentist

Check to see if your dentist is in our network and view dental providers who accept your plan

Find a dentist

Need help?

We can help you get coverage.

Call: 1-844-829-8513 (TTY 711)

Monday - Thursday: 8 a.m. to 5:30 p.m.
Friday: 9 a.m. to 5:30 p.m.