|
2024 Dental Premiums |
Per Pay Period |
|
Employee |
$11.16 |
|
Employee/Spouse |
$22.33 |
|
Employee/Child(ren) |
$27.91 |
|
Family |
$39.08 |
Procedure Coverage and Limits (Percentage shown per covered person)
Type I - Preventive Procedures: 100% Coverage
- Oral examinations
- Cleanings
- X-ray examinations
Type II - Basic Procedures: 80% Coverage
- Fillings
- Oral surgery (excluding surgical removal of impacted teeth)
- Simple extractions
- Stainless steel crowns
Type III - Major Procedures: 50% Coverage
- Bridges
- Crowns, inlays and onlays
- Dentures
- Implants
Type IV - Orthodontics Procedures: 50% Coverage
Examples are limited and do not include all applicable services.
The deductible (per person per calendar year) does not include Type I Services and has a benefit limit of $50. The calendar year maximum for Types I, II and III combined per covered person has a benefit limit of $1,500. The lifetime maximum (orthodontics per covered person) for Type IV has a benefit limit of $1,500.
For more information about Phelps Health's benefits, please contact Cathy Moore at (573) 458-7168 at cmoore@phelpshealth.org.