100%
preventive coverage (most plans)
80%
basic procedures
50%
major procedures
How Coverage Breaks Down
Preventive (100%): cleanings, exams, X-rays — the stuff that keeps you healthy
Basic (80%): fillings, simple extractions, root planing
Major (50%): crowns, bridges, root canals, implants
Orthodontic: some plans include a lifetime benefit of $1,000-$2,000
What's Usually NOT Covered
Cosmetic whitening and veneers
Adult orthodontics on some plans
Implants on older plans (though this is changing)
Anything above your annual maximum (typically $1,000-$2,000/year)
Most plans reset January 1. Unused benefits don't roll over — use them or lose them.
How to Maximize Your Benefits
Use both covered cleanings every year — they're free to you
Schedule major work before your annual max resets
Split big treatment plans across two benefit years if possible
Use HSA or FSA funds to cover your out-of-pocket portion
Not sure what your plan covers? Our coordinator Denielle will check for you. See our insurance info or book an appointment.