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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