City of Detroit Actives

Class I - Preventive (exams, cleanings, x-rays, etc.)

100% †

Class II - Basic (fillings, repairs, etc.)

85% †

Class III - Major (bridge, dentures, root canals, oral surgery, etc)

80% †

Class IV - Specialty Care (oral surgery, endodontics, periodontics, pedodontics)

50%

Deductible

None

Primary Care Maximum

$2,500

Specialty Care Maximum

$800

Orthodontic Maximum (Lifetime)

$1,800 discount up to age 19, $1,200 discount ages 19+ (comprehensive cases only)

Class I - Preventive (exams, cleanings, x-rays, etc.)

100% †

Class II - Basic (fillings, repairs, etc.)

85% †

Class III - Major (endo, perio, oral surgery at a general dentist)

80% †

Class IV - Specialty Care (when performed at a specialist)

50%

Deductible

None

Primary Care Maximum

$3,500

Specialty Care Maximum

$1,000

Orthodontic Maximum (Lifetime)

$3,000 benefit per family member