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8
The United HealthCare dental plans allow you to visit any dentist you would like—in or out-of-network.
Visiting an in-network dentist, however, assures you that you will not be balance billed by the provider for
any charges in excess of United HealthCare’s negotiated fees.
To find a network provider, go to
myuhcdental.com, then select
Find A Dentist
under Links and Tools. Enter
the State where you work/live and choose the
DENTAL OPTIONS PPO
network. Enter your search criteria.
DENTAL PLANS
Type of Plan
Calendar Deductible
In-Network
Out-of-Network^
In-Network
Out-of-Network^
Individual
$50
$100
Family
$150
$300
Calendar Year Maximum Benefit
$1,500 per individual $1,000 per individual
Class I - Preventive Services
(oral exam, cleaning, x-rays)
Plan pays 100%:
Deductible waived
Plan pays 80%;
Deductible waived
Class II - Basic Services
(fillings, simple extractions)
Plan pays 90%*
Plan pays 80%*
Class III - Major Services
(oral surgery, crowns, dentures)
Plan pays 60%*
Plan pays 50%*
Orthodontic Services
Orthodontic Lifetime Maximum
(children to age 19)
^Subject to Usual, Customary and Reasonable charges; *Coinsurance applies after Deductible is met
$50
$150
$750 per individual
Plan pays 40%*
Plan pays 20%*
Low PPO
Dental Coverage - United HealthCare
$750 per child
High PPO
$1,500 per child
Plan pays 50%
Plan pays 50%
Plan pays 100%:
Deductible waived