Dental coverage as simple, easy and affordable as you always wanted it to be.
Plan II features:
- No waiting periods on preventive care—Including immediate coverage for cleanings twice a year.
- Choose any dentist—In-Network or Out-of-Network, you can enjoy the same great coverage.
- Affordable—No deductible for preventive services, and a $1,000 annual maximum.
|Dental Services||In-Network / Out-of-Network Dentist||Waiting Periods|
Diagnostic and Preventive Services
|Diagnostic and Preventive Services* |
exams and cleanings twice a year, bitewing X-Rays, and fluoride treatments to age 14.
Used to detect oral cancer
|Emergency Palliative Treatment*||50%||None|
|Periodontal Maintenance |
Maintenance following active periodontal therapy
|Minor Restorative Services|
silver and white fillings
|Other Basic Services|
Services performed by a dentist during after-hours visits
|Denture and Bridge Repairs and Relines||50%||12 months|
|Oral Surgery Services |
extraction and dental surgery, including local anesthesia, suturing, and post operative care
|Endodontic Services |
|Periodontic Services |
Treatment for diseases of the gums and supporting structures of the teeth
|Prosthodontic Services |
Bridges, dentures and implants
|Crown and Cast Restorations|
Metal and porcelain crowns
|TMD Treatment |
Treatment for jaw and facial joint disorders
Maximums and Deductible
|Policy Year Maximum||$1,000 per member||-|
|Deductible (per benefit year)|
*Deductible waived for these services
|$50 per member/ $150 per family||-|
Note: This policy provides DENTAL insurance only. The expected benefit ratio for this policy is 69.5 percent. This ratio is the portion of future premiums that the company expects to return as benefits, when averaged over all people on this policy.
NOTES: These summaries are samples of benefits. Policies have exclusions and limitations that may limit coverage. Renaissance Dental Plan III and II may not be available in all states. For complete coverage details, please refer to your policy, INVD-100A--(state specific abbreviation, if applicable).
EXCLUSIONS: Cosmetic surgery or dentistry for aesthetic reasons (except reconstructive surgery for children because of congenital disease or anomaly); general anesthesia and/or intravenous sedation; treatment by anyone other than a licensed dentist or dental hygienist; veneers; sealants; prefabricated crowns as final restoration on permanent teeth and paste-type root canal filings on permanent teeth; appliances; procedures and restorations for increasing vertical dimension, occlusion, tooth structure loss due to attrition, abrasion or erosion, or for periodontal splinting; orthodontic services; space maintainers; lost, missing or stolen appliances; services not in the Policy and/or Summary of Dental Plan Benefits.
LIMITATIONS: Coverage for services may be limited based on the age of the person receiving the services; coverage for certain services may be limited to a maximum number of occurrences during a specified time period (such as two times per year or one time every three years); coverage for temporomandibular disorders (“TMD”) is limited.
The premium rate will vary between plans. The policy has a term of one year and will automatically renew (upon payment of required premium) unless terminated in accordance with the policy provisions. Coverage may be terminated for reasons stated in the policy. Coverage ceases upon termination of the policy. Products and services referred to herein may not be available in all states or jurisdictions.