Restorative Plus Dental Plan

Restorative Plus Plan Description

Please contact a Regional Vice President of Sales to discuss how we can provide the benefit design to fit your needs.

	In-Network	Out-of-Network

Exam	100% Covered	Fee Schedule
Adult Prophylaxis	100% Covered	Fee Schedule
Full Mouth x-ray	100% Covered	Fee Schedule
Panoramic	100% Covered	Fee Schedule
Bite-wing x-rays	100% Covered	Fee Schedule
Amalgam	100% Covered (after $50 Deductible*)	Fee Schedule

Additional Services	Discounted Fee Schedule	Discounted Fee Schedule
* $50 deductible applies to each covered member. Maximum of $150 for three members.