High End Plan |
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DENTAL INSURANCE-(Top End Plan) Maximum Coverage ………………..$3000.00 Plan Year…………………………….Calendar Year Deductible…………..……………….None/ $50.00 per year Payment…………………………… UCR Preventive ……………………………100%, deductible waived Basic………………………………….. 80%, increase to 100% after 3 years Major ………………………………. .. 50%, increase to 100% after 3 years Cleanings……………………………..2 per year Periodontal Maintenance………………4 per year Sealants……………………………… to age 16 Prosthetic Replacement……………. Replacement after 5 years Full Mouth X-rays………………… Every 3 years Dependent Coverage………………...To age 19, to age 23 if full time student Orthodontic Maximum………………$3000.00 Ortho Percentage…………….Paid as basic Ortho Age limits……………… none Accepts uniclaims…………………….Yes Accepts electronic claims…………….Yes Pre-Determination………………….. Not required Assignment of benefits……………… To dentist with valid assignment Notes And LimitationsNo waiting period Night guards paid as basic Diagnostic x-rays ( panorex, tomograms, CT scan paid as basic ) Implants paid at major Porcelain veneers paid at major Treatment for temporalmandibular joint (TMJ) dysfunction paid as major
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Return to The Nuts & Bolts of Dental Insurance Top ©1998, Jeffrey Kohlhardt DDS, 1204 Cottonwood Street, Suite 4
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