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Dental PPO

With this dental plan, you can see any dentist you want, anywhere across the country. However, when choosing a network dentist who is part of the plan's large national network, you may receive discounted rates only available to members.

Referrals are not needed to see a specialist.

Preventive care, including routine exams and cleanings, is covered 100% in the network. Oral cancer screenings are available to adults as part of the preventive care benefit. Extra dental visits may be covered during pregnancy and the first 3 months after birth*.

Summary

Deductible
Network Out-of-Network
Individual N/A N/A
Family N/A N/A
Annual Maximum
Network Out-of-Network
Individual N/A N/A
Family N/A N/A
Diagnostic and Preventive Services
Network Out-of-Network
Routine Exams and Evaluations N/A N/A
Cleanings N/A N/A
Labs and Other Diagnostic Tests N/A N/A

Network Coverage

Network dentists recommended, out of network dentists allowed

Preventive care

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

Annual Maximum

This plan includes an annual maximum which is the most the plan will pay for the plan year

Copays

No copay for services

Primary Care Dentist and Referrals

No primary care dentist or referral to see a specialist required.

Deductible
Network Out-of-Network
Individual N/A N/A
Family N/A N/A
Annual Maximum
Network Out-of-Network
Individual N/A N/A
Family N/A N/A
Diagnostic and Preventive Services
Network Out-of-Network
Routine Exams and Evaluations N/A N/A
Cleanings N/A N/A
Labs and Other Diagnostic Tests N/A N/A

Are your providers in network?

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

Search the Provider Network button Opens in a new tab

Coverage highlights

Cost sharing

Most dental plans share the same idea: there’s what you pay for care, when you pay for it, and how much of those care costs you and your plan share. 

You pay a deductible

For services other than preventive care, you pay a deductible - a set dollar amount - before your coverage kicks in.  

You pay coinsurance

As soon as the deductible is met, you and the plan will share the costs of services you received. Known as coinsurance, this is the percentage of costs you pay for covered dental care.

Your plan pays until it reaches the annual maximum

The plan pays for services up to a set dollar amount, called an annual maximum. If you reach the maximum amount, you’ll need to pay the entire cost of any additional dental care you receive that year.

Programs

Dental plan programs designed to help you keep your teeth and gums healthier while helping you control costs.

Dreaming of a straighter, brighter smile?

Now available as part of this plan's orthodontic benefit, SmileDirectClub straightens teeth with clear aligners sent directly to you. This means your dental plan may help your get the smile you’ll love.

If you are a candidate, the dental plan may pay half the cost of your aligner treatment. Your benefit also includes these services at no extra cost:

  • A 3D digital image at one of 235 SmileShops ($0 cost) or an at-home impression kit ($0 cost after reimbursement)
  • A retainer following completion of your smile journey ($0 cost with subscription)
  • bright on™ premium teeth whitening ($0 cost)
  • A duly licensed dentist or orthodontist will be assigned to you to develop your treatment plan and monitor your progress
See if you are a candidate and learn more Opens in a new tab

Dental FlexAppeal Enhanced Program

The FlexAppeal Enhanced program is part of your UnitedHealthcare dental plan. Designed to help you keep your teeth and gums healthier, this program includes three benefits:

  • Additional cleanings or gum treatments for those who have been treated for a periodontal (gum) condition. Your dentist will advise on the need for this.
  • White fillings for back teeth
  • Dental implants

Consumer MaxMultiplier Program

Our Consumer MaxMultiplier® program rewards you for keeping up with your dental care by adding dollars to the following plan year's annual maximum. These dollars can be used to pay for qualifying claims, excluding orthodontic services.

To qualify

  1. You’ll need to visit a dentist at least once during the plan year
  2. Your dental claims must be less than an amount set by the plan.

Each family member covered by your plan can earn his or her own awards. Members will not actually earn cash that they can access or withdraw.

Step-up Preventive Plan

Our Step-up Preventive Plan design rewards you for completing preventive care.

When you complete your preventive care requirements in plan year 1, you'll "step-up" to a higher coinsurance benefit in year .

If you satisfy preventive care requirements in year 2, the benefit "steps up" again in plan 3.

If you don't meet the requirement during the following year, the benefit will "step down" to the prior year's percentage.

If you don't meet preventive care requirements will not see a change in their benefit. The Step-up Preventive feature is designed to encourage members to take advantage of preventive care services.

  • * Not available in all states.

    UnitedHealthcare dental coverage underwritten by UnitedHealthcare Insurance Company, located in Hartford, Connecticut, UnitedHealthcare Insurance Company of New York, located in Islandia, New York, or their affiliates. 

    Administrative services provided by Dental Benefit Providers, Inc., Dental Benefit Administrative Services (CA only), DBP Services (NY only), United HealthCare Services, Inc. or their affiliates. Plans sold in Texas use policy form number DPOL.06.TX, DPOL.12.TX and DPOL.12.TX (Rev. 9/16) and associated COC form numbers DCOC.CER.06, DCOC.CER.IND.12. TX and DCERT.IND.12.TX. Plans sold in Virginia use policy form number DPOL.06.VA with associated COC form number DCOC.CER.06.VA and policy form number DPOL.12.VA with associated COC form number DCOC.CER.12.VA

  • SmileDirectClub is available to members enrolled in a UnitedHealthcare Dental PPO plan that includes orthodontic coverage. Not all individuals are suitable candidates for clear aligners. These services are intended for individuals who have mild or moderat orthodontic needs.

Enrollment Support

Need help or have questions about enrolling? Call our customer service number, Sun-Sat all day (24/7)

For Medical Emergencies, call 911

Member Support

Are you a current member with a question or looking for help? Call us at the number on your ID card.

Resources

Disclaimers

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