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Available Plans > > |
IND 101 |
IND 201 |
IND 301 |
IND 401 |
IND 501 |
Annual Deductible
(Per Contract Year) |
$0 |
$50 / family member |
$50 / family member |
$50 / family member |
$50 / family member |
Annual Maximum Benefit
Per Family Member
(Per Contract Year) |
Unlimited |
$1,500 |
$1,500 |
$1,500 |
$1,500 |
|
Class I
Diagnostic & Preventive Services
Oral Examinations
X-Rays
Cleanings
Flouride Treatments |
Covered at 100%
No waiting period |
Covered at 100%
No waiting period |
Covered at 50%
No waiting period |
Covered at 100%
No waiting period |
Not Covered
(Preferred Dentists accept the Maximum Alllowable Charge as payment in full) |
|
Class I
Diagnostic & Preventive Services
Palliative Treatment (Emergency) |
Covered at 100%
No waiting period |
Covered at 100%
No waiting period |
Covered at 50%
No waiting period |
Covered at 100%
No waiting period |
Covered at 60%
No waiting period |
Class II
Basic Services
Sealants
Space Maintainers
Repairs of Crowns, Inlays, Onlays & Dentures |
Not Covered
(Preferred Dentists accept the Maximum Alllowable Charge as payment in full) |
Covered at 80%
6-month waiting period |
Covered at 50%
6-month waiting period |
Covered at 80%
6-month waiting period |
Not Covered
(Preferred Dentists accept the Maximum Alllowable Charge as payment in full) |
Class II
Basic Services
Basic Restorative (Fillings, etc.)
Simple Extractions (Non-Surgical) |
Not Covered
(Preferred Dentists accept the Maximum Alllowable Charge as payment in full) |
Covered at 80%
6-month waiting period |
Covered at 50%
6-month waiting period |
Covered at 50%
6-month waiting period |
Covered at 60%
6-month waiting period |
|
Class III
Major Services
Complex Oral Surgery
Endodontics (Root Canals, etc.)
General Anesthesia and/or Nitrous Oxide and/or IV Sedation
Nonsurgical Periodontics
Surgical Periodontics
Crowns, Inlays, Onlays
Prosthetics (Dentures) |
Not Covered
(Preferred Dentists accept the Maximum Alllowable Charge as payment in full) |
Not Covered
(Preferred Dentists accept the Maximum Alllowable Charge as payment in full) |
Not Covered
(Preferred Dentists accept the Maximum Alllowable Charge as payment in full) |
Covered at 50%
12-month waiting period |
Covered at 60%
6-month waiting period |
| Orthodontia |
Not Covered
(Preferred Dentists accept the Maximum Alllowable Charge as payment in full) |
Not Covered
(Preferred Dentists accept the Maximum Alllowable Charge as payment in full) |
Not Covered
(Preferred Dentists accept the Maximum Alllowable Charge as payment in full) |
Not Covered
(Preferred Dentists accept the Maximum Alllowable Charge as payment in full) |
Not Covered
(Preferred Dentists accept the Maximum Alllowable Charge as payment in full) |
|
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(Colorado) |
Colorado
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Colorado
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Colorado
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Colorado
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Colorado
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(Texas / Arizona) |
Texas / Arizona
Quotes / Enrollment
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Texas / Arizona
Quotes / Enrollment
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Texas / Arizona
Quotes / Enrollment
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Texas / Arizona
Quotes / Enrollment
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Texas / Arizona
Quotes / Enrollment
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