Deductible | $50 individual $100 family |
---|---|
Annual Maximum Benefit (excludes orthodontia) | $2,500 per person |
Type of Service | Plan Pays |
---|---|
Preventive Care | Covered 100% in-network |
Basic Care | 20% |
Major Care | 50% |
Orthodontia | 50% |
Orthodontia lifetime maximum (The lifetime orthodontia max is separate from the annual maximum. The orthodontia benefit is only available for individuals up through age 19.) | $2,500 |