Page 15 - Trident 2022 Flipbook

DENTAL COVERAGE

You save money when using providers who
participate in United Concordia’s Elite Plus
It’s important to have regular dental exams and Network, as out of network providers can bill

cleanings so problems are detected before they over maximum allowable charge that United
become painful—and expensive. Keeping your Concordia will allow which means that the
teeth and gums clean and healthy will help provider may bill you the difference.
prevent most tooth decay and periodontal
disease and is an important part of maintaining To check for participating providers, go to:
your medical health. www.unitedconcordia.com

The Texas Rangers’ dental plan is through United
Concordia. You do not need to elect medical to
enroll in dental coverage.
Benefit In-Network Out of Network
Your dental plan provides coverage for routine
exams and cleanings and pays for a portion of
other services, as shown in the displayed table Annual Deductible $50 Individual $50 Individual
chart. $150 Family $150 Family

United Concordia Dental’s standard exclusions Annual Maximum
and limitations apply. (Per Person) $1,500 $1,500

Class I: Diagnostic and
Preventive Includes Exams, 100% 100%
Cleanings and Fluoride (No Deductible) (No Deductible)
Treatments

Class II: Basic Services
Includes Fillings, 80% after 80% after
Periodontics, Endodontics, Deductible Deductible
Complex Oral Surgery
Class III: Major Services
50% after
50% after
Includes Inlays, Onlays, Deductible Deductible
Crowns, and Prosthetics
50% after 50% after
Orthodontia Deductible Deductible
(Dependent Children up to $1,500 Lifetime $1,500 Lifetime
Age 19)
Maximum Maximum

The above is a brief summary of this benefit option.

Click here for more detailed information on this available benefit option.

2022 Trident Benefit Guide Page 15