The Individual Value Plan offers dental coverage for individuals and families. With FREE exams, low co-payments and a complete list of dental procedures, preventive care is easy! In addition, this Plan offers specialty care* and orthodontic coverage.
- Immediate Coverage
- PY2020 Plan IN Schedule of Benefits
- Orthodontia (Braces) Benefits
Availability:
Plan Type:
Deductible:
$0
Annual Maximum:
$2000 Primary Care
$500 Specialty Care Coverage
(per person / year)
Waiting Period:
Primary Care: None
Specialty Care: 6 months
Requirements:
This plan requires the main subscriber to be 18 years of age or older.
Network:
DENCAP DHMO Network
Office Visit:
$10
Exam:
FREE
Full Mouth X-Ray Series:
$36
Adult Cleaning:
$10
Filling:
$72
This plan requires the main subscriber to be 18 years of age or older.
Dental Savings:
-
Average Cost
$74
Your Co-Payment
FREE
Rates are approximates based on standard industry UCR
-
Average Cost
$123
Your Co-Payment
$36
Rates are approximates based on standard industry UCR
-
Average Cost
$79
Your Co-Payment
$10
Rates are approximates based on standard industry UCR
-
Average Cost
$243
Your Co-Payment
$72
Rates are approximates based on standard industry UCR
-
Average Cost
N/A
Your Co-Payment
$10 co-pay
Rates are approximates based on standard industry UCR
per month, billed montly
if billed annually
person(s)
