CA Select Managed Care Direct Compensation Dental Plan - CA250 (D1065)

Get coverage on hundreds of services including crowns, adult and child orthodontics (braces), silver fillings and more. Preventive care, including routine exams, cleanings and fluoride treatment is covered 100% in the network. In addition, expectant mothers get extra coverage for cleanings both during pregnancy and three months following delivery (benefit not available in all states). Oral cancer screenings are covered for adults age 18 and older.

Summary

Deductible
Network Out-of-Network
Individual $0 $0
Family $0 $0
Annual Maximum
Network Out-of-Network
Individual $0 $0
Family $0 $0
Diagnostic and Preventive Services
Network Out-of-Network
Routine Exams and Evaluations 100% Covered 100% Covered
Cleanings 100% Covered 100% Covered
Labs and Other Diagnostic Tests 100% Covered 100% Covered

Network coverage

Network dentists only

Preventive care

Preventive care provided by a network dentist is covered at 100%

Annual maximum

This plan does not include an annual maximum

Copays

Copay due for certain services

Primary care dentist and referrals

No primary care dentist required. Yes, a referral to see a specialist is required.

Deductible
Network Out-of-Network
Individual $0 $0
Family $0 $0
Annual Maximum
Network Out-of-Network
Individual $0 $0
Family $0 $0
Diagnostic and Preventive Services
Network Out-of-Network
Routine Exams and Evaluations 100% Covered 100% Covered
Cleanings 100% Covered 100% Covered
Labs and Other Diagnostic Tests 100% Covered 100% Covered

Summary

Network coverage

Network dentists only

Preventive care

Preventive care provided by a network dentist is covered at 100%

Annual maximum

This plan does not include an annual maximum

Copays

Copay due for certain services

Primary care dentist and referrals

No primary care dentist required. Yes, a referral to see a specialist is required.

Are your providers in network?

Find out if your dental care provider is in the network.

Coverage highlights

  • Plan benefits

  • Provider network