Dental Benefits

Deductible (Individual/Family)

$50/$100

$50/$100

Annual Maximum Benefit per Person

$1,500

$1,500

Type I - Preventative Services

100%

100%

Type II - Basic Services

90%

80%

Type III - Major Services

60%

50%

Type IV - Orthodontia Services

50%

50%

Orthodontia Lifetime Maximum

$1,000 per child

$1,000 per child

Dependent Limiting Age

Under 19

Under 19

MAX Advantage

Claims paid for cleanings, exams, x-rays, and fluoride treatments do not apply toward annual benefit maximum.