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Dental Plan
High Option- Plan Dentist
Plan 100- The Money Saver
| Members Services |
Member
Pays
1st year
|
Member
Pays
2nd year
|
| Diagnostic Services-
100% Savings Oral
Examination and diagnosis
Full Mouth x-rays (once every 5 years)
Prophylaxis (once every 6-months)
Vitality Test, Emergency Pain Relief
|
N/C
N/C
N/C
N/C |
N/C
N/C
N/C
N/C |
| Restorative Dentistry-
100% savings Amalgam
filling, primary and permanent teeth
(One Surface)
Composite, acrylic, plastic restorations
(One surface), Sedative base
|
N/C
N/C |
N/C
N/C |
| Crown and Bridge- 75%
savings Porcelain
with Metal (non-precious)Crown/Bridge
(per unit)
Composite, acrylic, plastic restorations
Sedative base
|
285.00
N/C |
215.00
N/C |
| Periodontics / Endodontics- 80% savings Subingival curettage, per quadrant
Pulp capping / Recalcification
Culturing Canal
Root canal Therapy (one root)
|
65.00
N/C
N/C
55.00 |
45.00
N/C
N/C
55.00 |
| Prosthetics- 85%
savings Complete
upper and lower denture, per denture
Denture adjustments
|
445.00
N/C |
205.00
N/C |
| Oral Surgery- 90%
savings Alveolectomy,
per quadrant
Post-operative visits
Simple extractions, uncomplicated
Impactions- Erupted/Soft Tissue
Local analgesia
|
N/C
N/C
15.00
50.00
N/C |
N/C
N/C
15.00
50.00
N/C |
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Considerable effort went into preparing the on-line materials on this WWW server, and we try to keep the information correct and up-to-date. However,
Benefits Unlimited and its agents shall not be held liable for any damages, however caused, by errors or omissions that may have occurred in the preparation of these pages.
Prices and conditions subject to change and are only a brief summary of the complete benefits.
Copyright 1997. No
information contained in this document may be reproduced
without express written consent of the author.
Last revised: December 09, 2002.
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