Dental Benefits

United Concordia Dental Plans
Low Plan High Plan
Deductible
Individual $50 $50
Family $150 $150
Plan Year Maximum
(July 1 - June 30)
$1,000 per person (combined Basic and Major services) $1,500 per person (combined Basic and Major services)
Preventive Care (does not count towards plan year maximum)

- Oral Exam
- Cleanings
- Bitewing X-Rays
- Fluroide treatments
100%, no deductible 100%, no deductible
Basic Care

- All other X-rays
- Sealants
- Pallative treatment
- Space maintainers
- Basic restorative
- Simple extractions
80% after deductible 80% after deductible
Major Care

-Endodontics
-Surgical and non-surgical
periodontics
-Complex oral surgery
- General anesthesia
- Inlays/Onlays
- Crowns and crown repairs
- Denture repairs
50% after deductible 50% after deductible
Orthodontia

- Dependents under age 19($1,500 maximum lifetime benefit)
N/A 50%
Smile for Health® - wellness* Covers 1 additional maintenance per year and all are covered at 100%, and 4 periodontal surgery procedures are coverage at 100%. Covers 1 additional maintenance per year and all are covered at 100%, and 4 periodontal surgery procedures are coverage at 100%.


*Members (subscribers or covered dependents) with certain medical conditions must sign up for this program through My Dental Benefits on UnitedConcordia.com