• no charge services
  • examinations
  • x-rays
  • routine cleanings
  • fluoride treatments
• other services at predetermined co-payments
  • implant benefit
  • orthodontic co-payments for adults and children
  • specialty care available at a 15% to 25% discount of participating specialists’ normal fees
• additional plan features
  • no deductibles
  • no claims forms
  • no annual dollar maximum
  • all pre-existing dental conditions are covered
  • No waiting periods

Preexisting conditions

Limitations and exclusions apply with respect to the Member’s oral conditions without regard to whether or not such conditions existed before the effective date of the Member’s enrollment.
 

Orthodontic extractions

Extractions by a Plan Provider for solely orthodontic purposes are not subject to the fixed Co-payments shown for extractions in the Co-payment Schedule. Instead, such extractions are subject to charges reflecting a 25% reduction from that Plan Provider’s normal retail charges for such extractions.
 

Termination

The Member’s enrollment may be terminated as stated in the TERMINATION article of the Evidence of Coverage.