Underwritten by United Concordia
Benefits & coverage
Annual Max Benefit
Restorative Services Waiting Period
Major Services Waiting Period
Oral Evaluations (Exams)
Cleanings & Fluoride Treatments
Full Mouth X-rays
Palliative Treatment (Emergency)
Adjunctive General Services Consultations
Repairs of Crowns, Inlays, Onlays
Resin Based Composite - Posterior (White Filling)
Resin Based Composite - Anterior (White Fillings)
Single or Stainless Steel Crowns
Root Canal Retreatment
Endodontic Therapy (Root canals, etc.)
Apicoectomy/Periradicular (Root Surgery)
Nonsurgical and Surgical Periodontics
General Anesthesia, Nitrous Oxide and/or IV Sedation
Removable Complete and Partial Dentures
Adjustments and Repairs of Complete and Partial Dentures
Dental Limitations & Exclusions
The following services, supplies or charges are excluded:
Covered services are limited as detailed below. Services are covered until 12:01 a.m. of the birthday when the patient reaches any stated age:
Frequently Asked Dental Questions
United Concordia Dental plans include coverage for necessary dental treatments in three different classes of service, which may be subject to exclusions, limitations and waiting periods.
Plans vary in both the level of coverage (coinsurance) and the class of covered services. If you have good oral health, and just need preventive care, you may not need a comprehensive plan. You may want to select a plan that covers Restorative and Major services if your needs extend beyond preventive care. Another plan feature, and advantage of selecting a network provider, is that the participating dentist may agree to discounted fees for non-covered services and services over the maximum.
You may choose any licensed dentist to provide services under this plan. If you choose a non-participating provider, you may be balanced billed the difference between the providers full charge and the plans allowance.
Yes, your plan is subject to an annual maximum on a calendar year basis.
Deductibles are per person, per calendar year. A covered person must pay any applicable deductible amount before covered benefits are payable under the plan chosen unless otherwise stated.
Reimbursement for Covered Services is based on the Maximum Allowable Charge for participating dentists. See your reimbursement addendum or schedule of benefits attached to the Certificate of insurance for information on reimbursement for non-participating dentists. Non-par reimbursement is detailed on the SOB in some states.
If a Covered person receives service for a procedure before the Benefit Waiting Period for that procedure ends, that procedure is not covered under the Policy. The Benefit Waiting Periods for Covered Procedures are listed in the Schedule of Benefits and vary by class of service.
The Coinsurance Percentage is the percentage of the Covered Expense that we will pay for a Covered Procedure. The percentage applicable to a Covered Person may vary by Covered Procedure and is shown in the Schedule of Benefits.
The Percentage of Covered Expense is the percentage of the Covered Expense that We will pay for a Covered Procedure. The percentage applicable to a Covered Person may vary by Covered Procedure and is shown in the Schedule of Benefits.
When a Covered Person has dental coverage under more than one Plan, as defined below, the benefits payable between the Plans will be coordinated.
Benefits will be adjusted so that the total payment under all Plans is no more than 100 percent of the total Allowable Expense, as defined in the policy. In no event will total benefits paid exceed the total payable in the absence of COB.
If a Covered Person’s Benefits paid under this Plan are reduced due to COB, each benefit will be reduced proportionately. Only the amount of any benefit actually paid will be charged against any applicable Plan Year Maximum Benefit.
Short Term Medical Insurance
Limited Fixed Indemnity Plans