Spirit Indemnity Dental Plan
This Dental Insurance Plan helps you cover the costs of dental care. Covered dental services include exams, cleanings, fillings and extractions, as well as crowns, bridges and dentures.
This policy pays you for covered dental expenses based upon a percentage of the Reasonable and Customary (R&C) fees for those covered expenses after the $50/$150 annual deductible (combined for Basic and Major Services) has been satisfied. These percentages are: 100% for Preventive Services, 70% for Basic and 10% for Major Services in the 1st year. In the 2nd year of coverage, Basic Services increase to 80% and 50% for Major. In the 3rd year, Basic Services increase to 90%.
Spirit Dental allows you to select your own dentist and is affordable for you and your family.
- Two exams per calendar year
- Three cleanings per calendar year
- Space maintainers
- One series of bitewing x-rays per year
- Sealants (children to age 16)
- One topical fluoride per year to age 16
- Simple extractions
- Implants (endosteal only), up to the allowance for the lowest cost covered traditional procedure
- One diagnostic x-ray, full or panoramic in any 3 year period
- Oral surgery
- Endodontic treatment
- Periodontic services
- Restoration services; inlays, onlays and crowns
- Prosthetic services; bridges and dentures
- Basic fillings
Calendar Year Maximums - $1,200, $2,500 or $3,500 per insured
- Deductibles are to a maximum of 3 Individual deductibles per family.
- $50/$150 combined Basic/Major annual deductible.
Reasonable and Customary
- Reasonable and customary means the usual, customary and regular charges for the area where such expenses are incurred.
*Spirit Indemnity not available in: Washington