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

$2,500.00

Specialty Care Maximum

$800.00

Orthodontic Maximum (Lifetime)

$1,800 discount up to age 19

Orthodontic Maximum (Lifetime)

$1,200 discount ages 19+ comprehensive cases only

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

100% †

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

100% †

Class III - Simple & surgical extractions, root canals

100% †

Class III - Major (bridges, dentures, limited crowns)

80% †

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

70%

Deductible

None

Primary Care Maximum

$3,500

Orthodontic Maximum (Lifetime)

$3,000 Benefit up to age 19, $3,000 Benefit ages 19+, Comprehensive cases only