Dental Coverage Level

Which Coverage Level Is Best?

You get to choose how much coverage you need and how you want to pay for it. When you choose your coverage level, you get to pick the one with the features you want.

Your coverage level determines how much you pay out of your paycheck (premiums). It also determines how much you pay out of your pocket when you receive care (deductibles, coinsurance, copays). Make sure to take your total costs into consideration when choosing a coverage level.

Don’t let the names of the coverage levels fool you. One option isn’t better than another. The coverage levels are designed to give you choices. It’s up to you to find the one that makes sense for your situation.

Dental Coverage Level Options

Bronze Silver Gold
Annual Deductible and Plan Limits
Annual deductible (individual / family)

$100 / $300

$100 / $300

$50 / $150

Annual maximum (excludes orthodontia)

$1,000 per person

$1,500 per person

$2,500 per person

Orthodontia lifetime maximum1

Not covered

$1,500 per child

$2,000 per person

In-Network Benefits
Preventive care

100% covered, no deductible

100% covered, no deductible

100% covered, no deductible

Minor restorative care (e.g., root canal treatment, gum disease treatment, and oral surgery)

You pay 20% after deductible

You pay 20% after deductible

You pay 20% after deductible

Major restorative care (e.g., crowns, implants, dentures)

Not covered

You pay 40% after deductible

You pay 20% after deductible

Orthodontia

Not covered

You pay 50%, no deductible; children up to age 19 only

You pay 50%, no deductible; for children and adults



Make It Yours To Go