Enhanced Care Plus Option D
|Annual Maximum Benefit||None|
|Teeth Cleanings||$0 copay|
|Restorative Dentistry/Fillings||Anterior: $15 copay; Posterior: $35 copay|
|Oral Surgery||$140 copay|
|Crowns||Restorative: $255 copay; Prosthodontic: $330 copay|
|Root Canals||$190 copay|
|Topical Fluoride||$0 copay|
|A.M. Best Rating||A as of 11/07/2019|
|Electronic Signature for Application Available||Yes|
|Details and documents about this plan|
|View Plan Brochure The carrier has not provided a separate document for Exclusions and Limitations.|
Important notices and disclaimers
- The information shown here is a summary of benefits for informational purposes only. Review the official plan documents (such as evidence of coverage, plan brochure, or insurance policy) for a detailed description of coverage benefits, limitations, and exclusions. Only the terms and conditions of coverage benefits listed in the policy are binding.
- The benefits listed may be contingent on your use of physicians, hospitals, dentists and services within the specific insurance company's provider network.
- The Copayment, Deductible, and Coinsurance amounts are your share of the costs for covered benefits. These amounts are subject to change.
- The quotes or rates shown above are estimates only. Your premium is subject to change based on your medical history (pursuant to state law of residence), the underwriting practices of the insurance company, the optional benefits you selected, if any, and other relevant factors, such as changes in rates which take effect before your requested effective date. The insurance company always determines your actual premium. Insurance companies reserve the right to change the terms of a policy upon proper notification.