• Individual Dental

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To qualify for and select an individual or family dental plan, you must enroll in a SelectHealth Individual or Family medical plan


Dental Traditional Plans 


If you choose a traditional plan, you must see participating providers on your SelectHealth Dental network. A buy-up option gives you access to nonparticipating providers.
Benefits​ ​Participating
​Nonparticipating
(optional buy-up)
Deductib​​le​
(Indiviual/Family)
$50/$150


Individual ​​​
$750/$1,000/$1,500
$750/$1,000/$1,500
Preventive and Diagnostic
(No waiting period)
Oral exams, cleanings, flouride, x-rays
No Charge/ No Charge/10% after deductible


2
0/20/30% after deductible
(Six month waiting period without prior coverage)
Fillings, oral surgery, anesthesia for basic services
20/20/30% after deductible
40/40/50% after deductible
Major
(12 month waiting period without prior coverage)
Crowns, bridges, dentures, anesthesia for major services, endodontics and periodontics
Plan pays 50% after deductible
Plan pays 60% after deductible


Dental Tiered Plans


This plan has access to both the Fundemental and the Prime networks. Additionally, you can see nonparticiating providers. This plan is designed to encourage use of the Fundamental network for the lowest out-of-pocket cost. 


 Benefits​ Fundamental Network Prime
Network

Nonparticipating


Deductib​​le​
(Indiviual/Family)
​​$0/$0
$50/$150
$100/$300

Individual
​​​
$2,000

​​ ​$1,000
Preventive and Diagnostic
(No waiting period)
Oral exams, cleanings, flouride, x-rays
​​No charge No Charge
 

No Charge
after deductible

(Six month waiting period without prior coverage)
Fillings, oral surgery, anesthesia for basic services
20% 20% after deductible 40% after deductible
Major
(12 month waiting period without prior coverage)
Crowns, bridges, dentures, anesthesia for major services, endodontics, and periodontics, anesthesia for major services
50%​ 50%​ after deductible

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