2019 Dental Plan Comparison Tool

What dental plan is right for you? This tool helps you compare the provisions of each plan side-by-side. Choose the plans you want to compare by selecting from the options below.

Your Plan Options

Select up to 2 plans to compare

Plan Overview
  Dental Plan 1 (No Cost) Dental Plan 2
  Network Non-Network Network Non-Network
Calendar Year Deductible The calendar year deductible applies to basic and major dental plan services only $50 per individual/ $150 family $50 per individual/ $150 family $50 per individual/ $150 family $50 per individual/ $150 family
Calendar Year Benefit Maximum The maximum amount paid for by the plan in a single plan year (may apply separately to each covered family member). Eligible preventive and orthodontia dental plan services are not applied to annual benefit maximum. $1,500 $1,500 $1,500 $1,500
Orthodontia Lifetime Benefit Maximum The maximum amount paid for by the plan for orthodontia services over the lifetime of each covered family member. Not Covered Not Covered $2,000 $2,000
Preventive Care Coinsurance The percentage of cost shared between you and the plan of a covered dental service, calculated as a percent of the usual, customary and reasonable charges. You pay coinsurance plus any deductibles you owe. For example - 100% coinsurance means you are responsible for 0% and the plan is responsible for 100%. 100% (No Deductible) 100% (No Deductible) 100% (No Deductible) 100% (No Deductible)
Basic Care Coinsurance The percentage of cost shared between you and the plan of a covered dental service, calculated as a percent of the usual, customary and reasonable charges. You pay coinsurance plus any deductibles you owe. For example - 80% coinsurance means you are responsible for 20% and the plan is responsible for 80%. 80% (After Deductible) 80% (After Deductible) 80% (After Deductible) 80% (After Deductible)
Major Care Coinsurance The percentage of cost shared between you and the plan of a covered dental service, calculated as a percent of the usual, customary and reasonable charges. You pay coinsurance plus any deductibles you owe. For example, under Dental Plan 1 - 50% coinsurance means you are responsible for 50% and the plan is responsible for 50%. Under Dental Plan 2 - 80% coinsurance means you are responsible for 20% and the plan is responsible for 80%. 50% (After Deductible) 50% (After Deductible) 80% (After Deductible) 80% (After Deductible)
Orthodontia Coinsurance The percentage of cost shared between you and the plan of a covered dental service, calculated as a percent of the usual, customary and reasonable charges. You pay coinsurance plus any deductibles you owe. For example - 50% coinsurance means you are responsible for 50% and the plan is responsible for 50%. Orthodontia is only covered under the Dental Plan 2. Not Covered Not Covered 50% (No Deductible) 50% (No Deductible)
Plan Details
  • Preventive Dental Services
      Dental Plan 1 (No Cost) Dental Plan 2
      Network Non-Network Network Non-Network
    Oral Exams Examinations to determine the overall health and hygiene of the mouth and measure the risk of tooth decay, root decay, and gum or bone disease. 100% 100% (of UCR) 100% 100% (of UCR)
    Bitewing X-Rays X-ray to evaluate and monitor the decay between teeth and show how well the upper and lower teeth line up. 100% 100% (of UCR) 100% 100% (of UCR)
    Cleaning/Polishing The use of dental instruments to remove tartar and deposits from the teeth. 100% 100% (of UCR) 100% 100% (of UCR)
    Fluoride Treatments Treatments to prevent tooth decay by making the tooth more resistant to acid attacks from plaque bacteria and sugars in the mouth. 100% 1 100% (of UCR) 1 100% 1 100% (of UCR) 1
    Sealants A plastic resin used in dentistry to coat the chewing surfaces of the back teeth to prevent the growth of cavity-causing bacteria. 100% 1 100% (of UCR) 1 100% 1 100% (of UCR) 1
  • Basic Dental Services
      Dental Plan 1 (No Cost) Dental Plan 2
      Network Non-Network Network Non-Network
    Amalgam or Composite Filling Treatments to fill cavities. Composite fillings generally are more expensive than amalgam. 80% after deductible 80% (of UCR) after deductible 80% after deductible 80% (of UCR) after deductible
    Oral Surgery Diagnosis and surgical treatment of diseases, injuries, and defects related to the functional and esthetic aspects of the face, mouth, teeth and jaws. 80% after deductible 80% (of UCR) after deductible 80% after deductible 80% (of UCR) after deductible
    General Anesthetics A drug or combination of drugs used to bring about a reversible loss of consciousness for a dental procedure. 80% after deductible 2 80% (of UCR) after deductible 2 80% after deductible 2 80% (of UCR) after deductible 2
    Root Canal Therapy Therapeutic treatment to relieve pain caused by infection or inflammation inside of the tooth. 80% after deductible 80% (of UCR) after deductible 80% after deductible 80% (of UCR) after deductible
    Periodontal Services Treatments for the area around a tooth, including gums, bone and supporting ligaments. 80% after deductible 80% (of UCR) after deductible 80% after deductible 80% (of UCR) after deductible
    Repair/Maintain Major Service Repairs or maintenance of services including inlays/onlays, crowns, bridges, removable dentures, and implants. 80% after deductible 80% (of UCR) after deductible 80% after deductible 80% (of UCR) after deductible
  • Major Dental Services
      Dental Plan 1 (No Cost) Dental Plan 2
      Network Non-Network Network Non-Network
    Inlays/Onlays Used for restoration of large cavities when either a crown or filling may cause structural damage to the tooth. 50% after deductible 50% (of UCR) after deductible 80% after deductible 80% (of UCR) after deductible
    Crowns "Cap" placed over a tooth to restore its shape and size, strength, and improve its appearance. 50% after deductible 50% (of UCR) after deductible 80% after deductible 80% (of UCR) after deductible
    Bridges Replace missing teeth to restore your smile, restore the ability to properly chew and speak, and prevent remaining teeth from drifting out of position. 50% after deductible3 50% (of UCR) after deductible 3 80% after deductible 3 80% (of UCR) after deductible 3
    Removable Dentures Replacement teeth attached to a pink or gum-colored plastic base. 50% after deductible3 50% (of UCR) after deductible 3 80% after deductible 3 80% (of UCR) after deductible 3
    Implants Metal posts or frames surgically positioned into the jawbone to mount replacement teeth. 50% after deductible3 50% (of UCR) after deductible 3 80% after deductible 3 80% (of UCR) after deductible 3
  • Orthodontia Services
      Dental Plan 1 (No Cost) Dental Plan 2
      Network Non-Network Network Non-Network
    Services and Supplies Coverage for orthodontic services and supplies. Only covered under the Dental Plan 2. Not Covered Not Covered 50% 50% (of UCR)
    Diagnostic Procedures Coverage for orthodontic diagnostic procedures. Only covered under the Dental Plan 2. Not Covered Not Covered 50% 50% (of UCR)
    Surgery Corrective jaw surgery to correct minor or major skeletal and dnetal irregularities, including the misalignment of jaws and teeth. Only covered under the Dental Plan 2. Not Covered Not Covered 50% 50% (of UCR)
    Appliances Coverage for orthodontic appliances. Only covered under the Dental Plan 2. Not Covered Not Covered 50% 4 50% (of UCR) 4