No deductibles
No calendar year maximum
Dentist Availablilty |
DMS Dental Network |
Co Payment |
$10 per office visit |
PREVENTATIVE |
|
Oral Prophylaxis-Cleanings |
100% |
Flouride Treatment |
|
Daignostic Xrays |
|
Routine Exams |
|
Sealants |
|
BASIC |
|
Restorative Services-Amalgam (silver) fillings |
60% |
MAJOR |
|
Periodontics-Treatment of Gum disease |
50% |
Endodontics-Root Canals |
|
Oral Surgery-Extractions |
|
Crowns, Inlays, Onlays |
|
Prosthetics |
|
Bridges |
|
Partials |
|
Dentures |
|
ORTHODONTICS |
|
Braces-standard 24 month treatment |
Discount Service |
This is a brief overview of coverage and for informational purposes only. It does not guarantee coverage. Please refer to your plan guide or contact DMS or your benefits administrator for more details. |
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