Results for Dental

What's Covered Under the Basic Option

With the Basic dental option, you get coverage for preventive and basic care, including sealants, bitewing X-rays and full-mouth X-rays.

You might consider the Basic option if you and your dependents do not anticipate needing much dental care, aside from preventive and basic care.

 Basic Option
Your Deductible


You + one or You + family

The Plan Pays: Preventive Care

Plan pays 100% Includes exams, cleanings, sealants, X-rays

Major Care

Not covered


Not covered

Temporomandibular Joint Dysfunction (TMJ)

Not covered

Annual Benefits Maximum


Reasonable and Customary Charges: The plan pays up to reasonable and customary (R&C) charges for out of network care. You are responsible for any cost difference if your expenses are more than the R&C limits.

A Note About Dental Services

There may be limitations to some of these benefits, including, but not limited to, the number of cleanings and oral exams covered in a calendar year, and time limitations for filling and crown replacements. For more information on services, go to Your Benefits™.