SMILE. WE'VE GOT YOU COVERED.
MEMBER DENTAL AND VISION BENEFITS.CHOICE PPO Basic
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 sent to you with your membership card.
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 for more information.
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 participating dentist in the Choice PPO network.
CHOICE PPO Basic benefits include
NO CHARGE for routine semiannual cleanings, oral exams and other preventive care
ADDITIONAL CLEANING covered for diabetics and expecting mothers
INCREASING COVERAGE after completing years 1 through
3 on the plan
3 on the plan
$50 DEDUCTIBLE per member
$1,000 ANNUAL MAXIMUM per person
"NO-CHARGE" PROCEDURES
account for over 65% of dental services most frequently performed for adults, and 90% of the most frequently performed services for children.1
ACCESS TO OVER
300,000
DENTISTS2
300,000
DENTISTS2
1 Dominion National - based on annual review of utilization data.
2 Dominion National Internal Performance Report, November 2017. Participating providers are subject to change.
2 Dominion National Internal Performance Report, November 2017. Participating providers are subject to change.
AFFILIATIONS AND RECOGNITION
