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Dental Plan

Dentist speaking with a mature patient during a dental exam.

 

Administrator: United Concordia Dental
Website:  www.ucci.com
Phone: 1-866-851-7564
Mobile App:  HERE 

The Traditional Dental Plan (Dental PPO) provides payment for the following covered services, subject to the plan maximums and limitations:

Class Schedule:

Class I Diagnostic and Preventive (no more than two in any calendar year). 100%  of reasonable and customary charges
Class II Basic Restorative, Endodontics, Periodontics, Maintenance of Prosthodontics and Oral Surgery 80%  of reasonable and customary charges
Class III Major Restorative, Installation of Prosthodontics 60%  of reasonable and customary charges
Class IV Orthodontics 60%  of reasonable and customary charges

The maximum benefit, excluding Class IV Services, is $2,000 per person each year. The lifetime maximum for Class IV Services (orthodontics) is $1,000 per person. Each year, you will need to meet a deductible of $50 per person, or $150 for family. The deductible does not apply to Class I Services. As an additional plan feature, if you use a dentist who is a member of the Preferred Provider Organization (PPO), charges for covered services will usually be discounted. This means your cost will usually be less than that associated with a dentist who is not a member of the PPO. Please remember that under the Traditional Dental Plan (Dental PPO), you may use any dentist you wish; use of the PPO feature is voluntary. You must submit any claims for services within fifteen (15) months following the date of service. 

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