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Standard Dental
Regular visits to your dentist can protect more than your smile; they can help protect your health. Recent studies
have linked gum disease to damage elsewhere in the body and dentists are able to screen for oral symptoms of
many other diseases including cancer, diabetes, and heart disease.
Standard Dental PPO
In-Network
Out-Of-Network
Calendar Year Deductible
$50
$150
$50 *
$150 *
Annual Plan Maximum
$1,500
$1,500 *
Diagnostic and Preventive
Services
Includes: Exam, Bitewing
X-rays, 2 cleanings per
year, sealants, space
maintainers, etc.
Plan pays 100%
Plan pays 100%
Basic Services
Includes: Fillings, Root
Canals, Amalgams,
Composites, Endodontics,
Periodontics, Denture
Repair, Simple Extractions
90% after deductible
90% after deductible
Major Services
Includes: Onlays, Crowns,
Crown Repairs,
Prosthodontics, Complex
Extractions, Anesthesia
60% after deductible
60% after deductible
Orthodontic Services
Not covered
Not covered
* Combined with in-network.
Helpful Tips:
Don’t forget your
dental cleanings!
Make sure to see an
in-network provider to
get the most out of
your dental plan
benefits.
Need major dental
work performed?
Contact your carrier
for a “pre-treatment
estimate.” This way
you know your share
of cost ahead of time.
Find a Dental Provider:
Go to:
www.standard.com/employer/insurance/group-dental
Click on find a dentist
Enter your City, State, Zip Code, and the type of provider you are
looking for
Select “Classic (PPO)” in the “Select a Network” drop down list
Select the type of Provider you are searching for from the
“Choose Specialties” drop down list
Click on “Search Now” and your results will be displayed