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Home/Dental Plans/Minnesota/Basics for Families and Individuals

Basics for Families and Individuals


Out of Network benefits are based on a covered fee schedule.

Preventive Care

In Network
You Pay
Exams, cleaning, X-rays, topical fluoride

Restorative Services

After 6 month waiting period
In Network
You Pay
Amalgam-One Surface; primary or permanent
Diagnostic Services
The coinsurance/copayment amounts listed are examples and may be found on the Schedule of Benefits. This plan may not be available in all Counties. Please visit the See Plans and Prices section at www.healthcare.gov to confirm availability in your area.

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