Preventative Services
|
►
|
Diagnostic
|
Not applicable/Individual Not applicable/Family
|
90%
|
$1,500.00/Year $0.00/Lifetime
|
additional information about coinsurance or maximums
|
►
|
Preventative
|
Not applicable/Individual Not applicable/Family
|
90%
|
$1,500.00/Year $0.00/Lifetime
|
additional information about coinsurance or maximums
|
Basic Restorative Services
|
►
|
Basic
|
Not applicable/Individual Not applicable/Family
|
90%
|
$1,500.00/Year $0.00/Lifetime
|
additional information about coinsurance or maximums
|
Root canals and gum disease
|
►
|
Endodontics
|
Not applicable/Individual Not applicable/Family
|
90%
|
$1,500.00/Year $0.00/Lifetime
|
additional information about coinsurance or maximums
|
►
|
Periodontics
|
Not applicable/Individual Not applicable/Family
|
90%
|
$1,500.00/Year $0.00/Lifetime
|
additional information about coinsurance or maximums
|
►
|
Temporal Mandibular Joint Dysfunction Services
|
Not applicable/Individual Not applicable/Family
|
90%
|
$1,500.00/Year $0.00/Lifetime
|
additional information about coinsurance or maximums
|
Oral surgery
|
►
|
Basic surgery
|
Not applicable/Individual Not applicable/Family
|
90%
|
$1,500.00/Year $0.00/Lifetime
|
additional information about coinsurance or maximums
|
►
|
Anaesthetics
|
Not applicable/Individual Not applicable/Family
|
90%
|
$1,500.00/Year $0.00/Lifetime
|
additional information about coinsurance or maximums
|
►
|
Major surgery
|
Not applicable/Individual Not applicable/Family
|
90%
|
$1,500.00/Year $0.00/Lifetime
|
additional information about coinsurance or maximums
|
Bridges, crowns and dentures
|
►
|
Basic prosthetic
|
Not applicable/Individual Not applicable/Family
|
90%
|
$1,500.00/Year $0.00/Lifetime
|
additional information about coinsurance or maximums
|
►
|
Major prosthetic
|
Not applicable/Individual Not applicable/Family
|
50%
|
$1,500.00/Year $0.00/Lifetime
|
additional information about coinsurance or maximums
|
Orthodontics
|
►
|
Basic
|
Not applicable/Individual Not applicable/Family
|
50%
|
$0.00/Year $1,500.00/Lifetime
|
additional information about coinsurance or maximums
|