Plan 1-2-3

Our Most Flexible Dental Insurance Plan

This plan is for individuals that think ahead. Full 100% preventative care available now. Basic & major services gradually increase over three years.

Plan A Plan B Plan 1-2-3

Basic Services (%)

20%
40%
80%
Yr. 1
Yr. 2
Yr. 3

Benefits for fillings, anesthesia and other basic or restorative services increase over the first three years.

Major Dental (%)

15%
30%
50%
Yr. 1
Yr. 2
Yr. 3

Benefits for crowns, root canals, dentures, bridges and other major services increase as well.

Maximum Benefit ($)

$500
$750
$1,250
Yr. 1
Yr. 2
Yr. 3

Your plan's maximum annual benefit starts at $500 and grows all the way to $1,250 by year three.

Plan 1-2-3 Details

Immediate full coverage for preventative and diagnostic care. No waiting period for basic and major dental services, and benefits increase over time.

Coverage
Year 1
Year 2
Year 3+
Preventative & Diagnostic:
Check-Ups
100%
100%
100%
Cleaning
100%
100%
100%
X-Rays
100%
100%
100%
Fluoride treatments
100%
100%
100%
Sealant Treatment
100%
100%
100%
Basic Dental Services
YEAR 1
YEAR 2
YEAR 3+
Root Canal
20%
40%
80%
Periodontics
20%
40%
80%
Filling/Other Services
20%
40%
80%
Anesthesia
20%
40%
80%
Oral Surgery
20%
40%
80%
Other Basic Services
20%
40%
80%
Major Dental Services:
YEAR 1
YEAR 2
YEAR 3+
Crowns
15%
30%
50%
Full Dentures
15%
30%
50%
Partial Dentures
15%
30%
50%
Repairs to Dentures
15%
30%
50%
Repairs to Bridges
15%
30%
50%
Other Major Services
15%
30%
50%
Deductibles & Maximums*
YEAR 1
Year 2
Year 3+
Preventative/Diagnostic
$0
$0
$0
Basic/Major Services
$50
$50
$50
Maximum Benefit
$500
$750
$1,250

*Annually, per insured. For family coverage, maximum deductible per family, per year of $150.

The benefit levels shown above indicate what the plan will pay when you visit an in-network dentist. If you decide to see an out-of-network dentist, the plan payment amounts may be higher. Please see FAQs for details.