DENTAL

Dental Insurance

Lincoln

DentalGuard Preferred PPO Network

Who is Eligible and When
All employees working 30 hours a week or more.

Dependent Children
Children are eligible until they turn 26.

Resources

Dental Benefits Schedule

Type of Service	Network Access Plan
Deductible (single/family)	$50/$150
Policy Year Maximum	$1,000
Diagnostic & Preventive Services Bitewing & Full Mouth X-Rays; Cleanings; Oral Exams; Sealants (per tooth)	No Charge
Basic Services Fillings (one surface); General Anesthesia; Scaling & Root Planing (per quadrant); Simple Extractions	20%
Major Services Crowns, Inlays, Endodontics Root Canal, dentures	50%
Orthodontia Maximum	50% $1,000 lifetime maximum

Please review the detailed benefit summary document for more information on the medical plans. Note: All In-Network Preventive care (coded as “preventive care” by your doctor) will be paid in full by Anthem.