|
Dental Plan
Low Option- Plan Dentist
Plan 500 A
| Members Services |
Member
Pays
1st year
|
| Diagnostic Services-
100% Savings Oral
Examination and diagnosis
Full Mouth x-rays (once every 3 years)
Prophylaxis (once every 6-months)
Vitality Test, Emergency Pain Relief
|
10.00
15.00
10.00
8.00 |
| Restorative Dentistry-
100% savings Amalgam
filling, primary and permanent teeth (One
Surface)
Composite, acrylic, plastic restorations (One
surface), Sedative base
|
16.00
20.00 |
| Crown and Bridge- 75%
savings Porcelain
with Metal (non-precious) Crown/Bridge (per unit)
Composite, acrylic, plastic restorations (One
surface), Sedative base
|
355.00
18.00 |
| Periodontics / Endodontics- 80%
savings Subingival curettage, per quadrant
Pulp capping / Pulpotomy / Recalcification
Culturing Canal
Root canal Therapy (one root)
|
75.00
15.00
20.00
105.00 |
| Prosthetics- 85%
savings Complete upper and
lower denture, per denture
Denture adjustments
|
495.00
10.00 |
| Oral Surgery- 90%
savings Alveolectomy, per
quadrant
Post-operative visits
Single extractions
Local analgesia
|
10.00
25.00
28.00
8.00 |
|
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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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