Benefit

Choice of Provider

Services are provided ONLY through Willamette Dental Group

Annual Deductible
(per calendar year)

Combined deductible with medical.

Annual Limit
(per calendar year)

$1500

Preventive/Basic Care
Exams, Cleaning, X-rays, fluoride, fillings, simple extractions, root canal therapy

100% (deductible waived)

Prosthetics
Dentures, bridges, crowns, inlays, space retainers

50%

Orthodontia

None