Oral health is an important part of your overall health. Group Health* has partnered with the Washington Dental Service (WDS) PPO Program to offer you this
dental plan as part of your complete Clear Care plan when you choose dental benefits. You have the freedom to use any dentist, with better benefits if you see a preferred provider. The dental plan is designed to provide you with full coverage for your semiannual dental checkups when you see a PPO provider so that dental health problems can be detected early.
| Cost shares |
| Per member/per month |
$49/month |
| Deductible |
$100 per person (waived on Class I) |
| Annual Maximum |
$1,500 per member |
| Class I: Preventive and diagnostic care |
- Routine exams and cleanings
(two times in a calendar year)
- Fluoride treatment
(two times in a calendar year)
- Periodontal cleanings
- Dental X-rays
|
Covered at 100% PPO provider; 80% non-PPO |
| Class II: Basic dental expenses |
- Fillings/stainless steel crowns
- Oral surgery
- Endodontics (i.e., root canal therapy)
- Periodontics
|
Covered at 80% PPO provider; 70% non-PPO |
| Class III: Major expenses |
- Crowns, implants, and onlays
- Dentures, bridges, and partials
- Denture adjustments and relines
|
Covered at 50% PPO provider; 40% non-PPO |
| * Group Health refers to Group Health Options, Inc. |
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