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Preventive
100% †
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Basic
85% †
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Major
80-85% †
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Orthodontics off UCR (up to age 19)
$1,800.00
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Orthodontics off UCR (over age 19)
$1,200.00
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Primary Care Maximum
$2,500.00
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Specialty Care Maximum
$800.00
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Total Annual Maximum
$3,300.00
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Complete List of Covered Benefits and Fixed Co-pays
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Provider Directory
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2021 City of Detroit Open Enrollment Information
† PERCENTAGES are APPROXIMATE, see co-payments as listed on the Schedule of Benefits and Fixed Co-Pays.