What You’ll Pay For Your Dental Care
Select a type of plan to find out how much you’ll pay.
Edit Benefit
No
Deductible
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No
Annual Benefit Limit
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$350
Individual Out-of-Pocket Maximum (child only)
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$700
Family Out-of-Pocket Maximum (2 or more children only)
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$0
Office Copay
Edit Benefit
No
Waiting Period for Children
Services
| Service | Price |
|---|---|
| Diagnostic and Preventive (includes x-rays, exams, cleaning and sealants) | Free |
| Amalgam Filling: One Surface | $25 |
| Root Canal: Molar | $300 |
| Gingivectomy, Per Tooth | $50 |
| Extraction: Single Tooth, Exposed Root or Erupted | $65 |
| Extraction: Complete Bony | $160 |
| Crown: Porcelain With Metal | $300 |
| Medically Necessary Orthodontia | $350 for children Not covered for adults |
Ready to care for your health?
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You can get help from a certified enroller right away. It’s always free and confidential. Talk to someone about your options and have them guide you through the process. You can enroll in person, by phone or online.
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