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MEMBER DENTAL AND VISION BENEFITS.

CHOICE PPO Basic

 

 

The Choice PPO Basic offers maximum access and no waiting periods.
Members may seek dental services from any licensed dentist or use a participating Choice PPO network dentist for greater coverage.
When dental care is received and expenses incurred, payments will be made in accordance with the list of benefits and services in the Coverage Schedule that will be mailed to you with your membership card. 
 
no waiting periods and no charge for oral exams, cleanings, bitewing x-rays and other preventive services.
 
More extensive care (fillings, dentures, crowns, root canals, periodontal care, oral surgery, etc.) is covered at increasing levels, progressing through years 1, 2 and 3 (please see the Plan Comparison chart).
Out-of-network dentists may charge above the amount covered by the Dominion plan, which will be balanced billed to you, the member. To ensure you do not receive additional out-of-pocket charges, visit a dentist in the Dominion Choice PPO network.

CHOICE PPO Basic benefits include

 
NO CHARGE for routine semiannual cleanings 
 
 
NO CHARGE for oral examinations
    NO CHARGE for bitewing x-rays
 
 
    $50 ANNUAL DEDUCTIBLE per member
 
 
    $1,000 ANNUAL MAXIMUM LIMIT per person

 

THESE "NO-CHARGE" PROCEDURES
account for over 65% of dental services most frequently performed for adults, and 90% of the most frequentlyperformed services for children.2

 

ACCESS TO OVER
290,000

DENTISTS
 
CHOICE PPO PREMIUM:
KIDS
By enrolling in the Choice PPO Basic, dependents under the age of 19 will automatically be enrolled in our pediatric dental plan. Review covered procedures.