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Dental
You can give your clients the option of adding
dental benefits to their overall program. The GHA 2 to 9 dental program
pays all covered reasonable and customary charges at the coinsurance
percentages shown in the schedule listed below:
Dental Benefits Schedule
| |
Option I |
Option II |
Option II |
| Calendar Year Maximum |
$1,000 |
$1,500 |
$1,500 |
| Deductible: Individual Family |
$ 50
$150 |
$ 50
$150 |
$0
$0 |
| Preventive Services (Class I) |
| Coinsurance Percentage: Diagnostic - General
Preventive |
100% |
100% |
100% |
| Basic Services (Class II) |
| Coinsurance Percentage: Restorative (Basic)
Endodontics Periodontics Prosthodontics- Removable (Maintenance)
Prosthodontics- Fixed Bridge (Maintenance) Oral Surgery) |
80% |
80% |
80% |
| Major Services (Class III) |
| Coinsurance Percentage: Restorative (Major)
Prosthodontics- Removable (Installation) (Maintenance) Prosthodontics-
Fixed Bridge (Installation) |
50% |
50% |
50% |
| Orthodontia (Class IV) |
| Coinsurance Percentage: 50% (child only until
age 18) Lifetime Maximum: $1,500 |
Not covered |
$50 deductible |
$50 deductible |
- No benefits are payable for Class III services
for late entrants.
- After a person has been continuously insured
for these benefits for 12 months, this late entrant limit will
no longer apply.
- If dental coverage is not selected prior to
the program's effective date, it may only be added at renewal.
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