Preventive care is covered at 100% with no waiting period. This includes two dental cleanings per year, routine X-rays, oral exams, fluoride treatments for children, and one comprehensive eye exam per year.
Are there waiting periods?
Preventive care has zero waiting period. Basic procedures like fillings have a 3-month waiting period. Major procedures like crowns and bridges have a 6-month waiting period. Complete and Family+ plans have reduced waiting periods.
What is the annual maximum benefit?
The Essentials plan has a $1,500 annual maximum. The Complete plan offers $2,500 per year. The Family+ plan provides $3,000 per member per year. Annual maximums reset every 12 months from your enrollment date.
Does my plan cover orthodontics?
Orthodontic coverage including braces and Invisalign is included in the Family+ plan with a $2,000 lifetime maximum per child. It is not included in the Essentials or Complete plans but can be added as a rider for an additional monthly premium.
What vision benefits are included?
All plans include one comprehensive eye exam per year with a $10 copay, a frame allowance of $150-$250 depending on plan tier, contact lens allowance, and discounts on LASIK. Designer frames from brands like Ray-Ban, Oakley, and Prada are included in-network.