Page 9 - Down East Wood Ducks 2022 Benefits Guide

DENTAL COVERAGE

You save money when using providers who

participate in United Concordia’s Elite Plus
Network, as out of network providers can bill
Your Dental Plan – United over maximum allowable charge that United

Concordia Concordia will allow which means that the
provider may bill you the difference.
It’s important to have regular
dental exams and cleanings so To check for participating providers, go to:
problems are detected before they www.unitedconcordia.com
become painful—and expensive.
Keeping your teeth and gums
clean and healthy will help prevent
most tooth decay and periodontal
disease and is an important part of Benefit In-Network Out of Network
maintaining your medical health.

The Down East Wood Ducks’ Annual Deductible $50 Individual $50 Individual
dental plan is through United $150 Family $150 Family
Concordia. You do not need to
elect medical to enroll in dental
coverage. Annual Maximum
(Per Person) $1,500 $1,500
Your dental plan provides
coverage for routine exams and
cleanings and pays for a portion of Class I: Diagnostic and Preventive 100% 100%
other services, as shown in the Includes Exams, Cleanings and (No Deductible) (No Deductible)
displayed table chart. Fluoride Treatments
Class II: Basic Services
United Concordia Dental’s Includes Fillings, Periodontics, 80% after Deductible 80% after Deductible
standard exclusions and limitations Endodontics, Complex Oral Surgery
apply.
Class III: Major Services
Includes Inlays, Onlays, Crowns, 50% after Deductible 50% after Deductible
and Prosthetics

50% after Deductible 50% after Deductible
Orthodontia $1,500 Lifetime $1,500 Lifetime
(Dependent Children up to 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 Down East Wood Ducks Benefit Guide Page 9