Affordable Dental and Vision Coverage

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Choice Dental

  • $500 annual max per person
  • Guaranteed Acceptance
  • No Age limit restriction
  • No Waiting Period
  • On your activation date, you have access to the full range of dental benefits Type 1, 2
  • $25 Copay per visit
  • All preventive dental care is covered 100%
  • No Deductibles
Preventive Services

Type 1 - COVERAGE 100%

  • Includes exams, cleanings, bitewing & full mouth x-rays, and fluoride treatments.
Basic Services

Type 2 - COVERAGE 80%

  • Includes fillings, sealants, restorative amalgams & composites, simple extractions and periodontal maintenance.
Major Services

Type 3 - NOT COVERED

monthly rates

Single Member: $25.00 Member + Spouse: $49.00 Member + Children: $59.00 Family: $79.00

Example: Family of 5 gets $2,500 in annual dental benefits

Premier Dental

  • $3,000 annual max per person Guaranteed Acceptance
  • No Age limit restriction
  • No Waiting Period*
  • On your activation date, you have access to the full range of dental benefits Type 1, 2
  • $25 Copay per visit
  • All preventive dental care is covered 100%
  • No Deductibles
Preventive Services

Type 1 - COVERAGE 100%

  • Includes exams, cleanings, bitewing x-rays, and fluoride treatments.
Basic Services

Type 2 - COVERAGE 80%

  • Includes fillings, full mouth x-rays, restorative amalgams & composites, simple extractions, sealants.
Major Services

Type 3 - 50% COVERAGE

  • Includes oral surgery, endodontics, all periodontics, dentures, crowns, bridges, anesthesia, complex extractions onlays and implants.

*12 month waiting period on Type 3

monthly rates

Single Member: $49.00 Member + Spouse: $94.00 Member + Children: $104.00 Family: $138.00

Example: Family of 5 gets $15,000 in annual dental benefits

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Lenses (Per Pair)

  • Single Vision; Bifocal; Trifocal; Lenticular - covered in full
  • Progressive - See Lens Options
  • Frequencies (months) Exam/Lens/Frames 12/12/24 *based on effective date of service

Contact Lenses

  • Fit & follow up exam - 15% discount
  • Elective - Up to $130
  • Medically necessary - COVERED IN FULL
  • Frequencies (months: Exam / Lens / Frames - 12/12/24 based on date of service

Lens Options (member cost)*

  • Progressive Lenses
    • Up to provider's contracted fee for lined bifocal lenses. The member is responsible for the difference between the base lens and the Progressive Lens charge.
  • Standard Polycarbonate: $33 / adult | COVERED IN FULL for dependent children
  • Solid Plastic Dye: $15 (except Pink I & II)
  • Photochromatic Lenses glass & plastic: $31 - $82
  • Scratch Resist Coating: $17 - $33
  • Anti-reflective Coating: $43 - $85
  • Ultraviolet Coating: $16
  • LASIK & PRK: see "ADDITONAL NETWORK FEATURES"

Monthly Premium Rates

Deductibles - $10 exams | $25 eye glass lenses or frames*

  • Single member: $14.00
  • Member + Spouse: $26.00
  • Member + Children: $24.00
  • Family: $35.00

*Reimbursement percentages are based on the usual and customary charges for services in your geographical area. All services are subject to limitations and exclusions.

Additional Network Features

  • Contact Lens Elective
    • Allowance includes fitting, exam, and lenses. The cost of the fitting and evaluation is deducted from the cost of the contact lens allowance. Allowance can be applied to disposables, but the dollar amount must be used all at once (3 - 6 month supply). Applies when contacts are chosen in lieu of glasses.
  • Additional Glasses
    • 20% off the retail price on additional pairs of prescription glasses (complete pair).
  • Frame Discount
    • 20% off the remaining balance in excess of the frame allowance.
  • Laser Vision Care
    • An average discount of 15% on LASIK and PRK. The maximum out of pocket per eye for members is $1800 for LASIK and $2300 for custom LASIK using WaveFront technology; and $1500 for PRK. In order to receive the benefit a network provider must coordinate the procedure.
  • Low Vision
    • With prior authorization, 75% of approved amount (up to $1000 is covered every two years).