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Health Plans - Group One

Oral Health And Overall Health

Your oral health says a lot about your overall health. Regular dental checkups are necessary to maintain your good health and the good health of your family. The human mouth teems with bacteria, most of which is normally kept in check by daily brushing and flossing. When harmful bacteria grows out of control, it causes tooth decay, gum disease and other problems. During a exam or dental checkup, dentists can detect much more than cavities and broken fillings. Dentists spot oral characteristics of certain medical conditions – from osteoporosis and diabetes to heart and kidney disease – before they become serious and costly to treat.

Take care of your oral health to help maintain your overall health. A ConnectiCare Dental plan can help you do that.

Dental Plan Benefit Summary for ConnectiCare SOLO Subscribers

$25 Deductible, 100%/0%/0%, Unlimited Maximum, No Ortho Coverage

Rates displayed are quoted rates only. Plans and rates are subject to approval by the Connecticut Insurance Department. Final rates are subject to change based on medical history, federal and state regulations, and ConnectiCare's underwriting guidelines.

COVERED DENTAL SERVICES

Participating
Provider
(In-Network
Level Of Benefits)
Non-Participating
Provider
(Out-of-Network
Level Of Benefits)*
Care Category
100%
100%
Diagnostic
100%
100%
X-Rays
100%
100%
100%
100%
Restorative**
0%
0%
Restorative-Crowns**
0%
0%
Endodontics**
0%
0%
Periodontics
0%
0%
Prosthetics - Removable**
0%
0%
Prosthetics - Adjustment**
0%
0%
Prosthetics - Fixed, Implants**
0%
0%
Extractions**
0%
0%
Bony Impactions**
0%
0%
Orthodontics**
0%
0%
General Services**

Deductibles and Maximums

Participating
Provider
(In-Network
Level Of Benefits)
Non-Participating
Provider
(Out-of-Network
Level Of Benefits)*
Unlimited
Unlimited
Annual Maximum Per Individual
$25.00
$25.00
Annual Deductible Per Individual
$0.00
$0.00
Orthodontic Lifetime Maximum Per Individual


Benefit year effective date is the Subscriber's Effective Date
As used herein, "Annual" means the benefit year in which dental care services are performed.

* For those subscribers electing to be served by a non-participating provider; submitted claims will be processed at any time during the benefit year and reimbursements will be made at the level of coverage listed under "Non-Participating Provider(Out-Of-Network Level of Benefits)" and in amounts up to the schedule of allowances paid to participating provider. Payments will be limited to the individual annual maximum listed above or that portion of the individual annual maximum, which may be remaining if care had previously been provided during the benefit year by a participating provider, subject to the plan’s deductibles and standard exclusions and limitations.

** Care Category (ies) of coverage the deductible applies to.