Dental Insurance

Dental Insurance is included with both the VDHP Medical Plan and the PPO Medical Plan options and is not changing. The dental coverage you have now will not change whether you elect the VDHP Medical Plan or PPO Medical Plan option.

As a reminder, the Dental plan covers two routine cleanings and checkups per year, at no cost to you. Dental insurance claims are also administered by UMR.

Type of Service
Calendar Year Deductible (Applies to Basic and Major Services Only)
Individual	$50
Family	$150
Annual Maximum (Class I, II, III Expenses)	$1,500
Diagnostic and Preventive Services: Class I (Exams, Cleanings, X-Rays)	100%
Basic Restorative Services: Class II (Fillings, Simple Extractions)	85%
Endodontics (Root Canals)	85%
Periodontics (Treatment Related to Gum Disease)	85%
Oral Surgery (Simple or Complex)	85%
Prosthetic Repairs and Adjustments	85%
Major Restorative Services: Class III (Crowns, Inlays, Onlays, Bridgework, Implants, and Dentures)	50%
Orthodontia: Class IV (Lifetime Maximum)	$2,000

This Plan does not limit a Covered Person’s right to choose his or her own provider of dental care at his or her own expense if a dental expense is not a Covered Expense under this Plan, or is subject to a limitation or exclusion. A provider who does not participate in a Network may bill the Covered Person for additional fees over and above what the Plan pays.