Additional premium for optional dental coverage
Freedom (excluding Basic) and Journey plans give you the option to buy supplemental dental coverage. It’s easy. You can purchase optional comprehensive dental coverage when you enroll in the plan.
For Freedom Vital and Balance, there is an additional monthly premium of $43.10. For Freedom Ultimate, there’s an additional monthly premium of $41.50.
For Journey, Pace, Stride and Dash, there’s an additional monthly premium of $43.10. For Journey Steady, there is an additional premium of $34.50.
No matter which plan you enroll in, the annual deductible for dental coverage is $50 per calendar year for regular and restorative care, and for special restorative care and prosthetics.
What’s included in the Comprehensive Dental?
You get 100 percent coverage for:
- Preventive and diagnostic care, including:
- Routine examinations and cleanings
- Other preventive services
You have 50 percent coverage for:
- Sealants, including pit and fissure sealants.
- Regular and restorative care, including:
- Oral surgery
- Periodontics (gum treatment)
- Endodontics (root canal therapy)
- Special restorative care, including:
- Restorative crowns
- Prosthetics, including:
- Partial dentures
Annual benefit maximum
The annual benefit maximum $1,100 per calendar year. $200 may be applied to out-of-network services.
For Freedom Vital, Balance and all Journey plans, preventive and diagnostic services do apply toward the annual maximum. For Freedom Ultimate, preventive and diagnostic services do not apply toward the annual maximum.
To receive the coverage listed above, you must use in-network dental providers and facilities. View your Evidence of Coverage (EOC) to get more info.
Last updated October 2019
H2462 H4882_118314 Accepted