Value Smile PPO

Details at a Glance

• Plan Type
• PPO
• Coinsurance
• None
• Deductible
• $25 individual
• Annual Maximum Benefit
• $500
• Office Visit
• No charge

Primary Benefits

• Teeth Cleanings
• No charge
• Restorative Dentistry/Fillings
• You pay $37 (One-surface Composite Filling)
• Oral Surgery
• Not Covered
• Extractions
• Not Covered
• X-Rays
• No Charge.
  Deductible Waived
• Crowns
• Not Covered
• Root Canals
• Not Covered
• Periodontics
• Not Covered
• Dentures
• Not Covered
• Topical Fluoride
• No Charge
• Sealant
• No Charge.
  Deductible Waived
• Bridges
• Not Covered
• Endodontics
• Not Covered

Additional Information

• A.M. Best Rating
• A as of 06/12/2012
• Electronic Signature for Application Available
• Yes
• Additional information about this health insurance plan is available in the documents below.
  Plan Brochure
  Exclusions and Limitations