Dental care benefits provide comprehensive dental services and supplies for plan members and their eligible dependants. The type and scope of dental services covered under a dental plan varies; however, dental care services are generally grouped into three major categories:
Basic services include coverage for diagnostic and preventative treatments, such as dental examinations, x-rays, cleanings, topical application of fluoride, oral hygiene, fillings, scaling of teeth, tooth extractions, periodontic services to treat the bone and gum around the tooth and endodontic services including root canal therapy.
Major restorative services include coverage for dentures, crowns, inlays, onlays and bridgework.
Orthodontic services include coverage for procedures and appliances, such as braces, wires, space maintainers and other mechanical aids required to straighten teeth and correct other defects.
The dental services are generally divided into several levels of coverage. At each level, a variety of plan design features, such as co-insurance, deductibles and maximums are available. Generally, the percentage reimbursement for Basic services is higher than the percentage reimbursement for Major Restorative and Orthodontic services.
Beginning with basic coverage, plan sponsors have the option of adding more comprehensive services including: