Dental
Dental coverage helps you maintain a healthy smile with preventive care, basic services, and major procedures. You can visit any licensed dentist, but you’ll save the most when you use an in-network provider who has agreed to discounted rates. Out-of-network dentists may charge more than the plan’s allowed amount, and you may be responsible for the difference. Most plans cover preventive services—such as exams, cleanings, and X-rays—at 100% when you stay in-network, making regular checkups an easy way to protect your oral health and avoid costly issues down the road.
Mutual of Omaha Dental
In-Network Benefit Highlights
Deductible (Individual/Family)
$XX/$XX
Out-of-Pocket Max (Individual/Family)
$XX/$XX
Preventive Care
$XX
Primary Care Visit
$XX
Specialist Visit
$XX
Urgent Care
$XX
Emergency Room
$XX
Benefit Highlights
In-Network
Deductible (Individual/Family)
$25/$75
Annual Plan Maximum (Individual/Family)
$3,000
Preventive Care
$0
Basic Services
10% coinsurance after deductible
Major Procedures
40% coinsurance after deductible
Orthodontia (Children)
50% up to a lifetime maximum benefit of $1,000
Out-of-Network
Deductible (Individual/Family)
$25/$75
Annual Plan Maximum (Individual/Family)
$3,000
Preventive Care
$0
Basic Services
15% coinsurance after deductible
Major Procedures
50% coinsurance after deductible
Orthodontia (Children)
50% up to a lifetime maximum benefit of $1,000
Plan Cost
Employee Only: $6.49
Employee and Spouse/DP: $71.52
Employee and Child(ren): $87.21
Employee and Family: $170.59