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Benefits Department • 800-562-6210, ext. 2495
Save money by using a provider in the UHC network. If you use an
out-of-network dentist, the plan will pay based on the Usual and
Customary rates for that procedure.
DENTAL COVERAGE
Plan Features
Annual Deductible
(waived for preventive services)
Diagnostic and Preventive Services
• Oral exams/cleaning – Two per 12 months
• Fluoride treatments (under age 16)
• X-rays, bitewings (once per year)
• Space maintainers to age 16
Routine Services
(e.g., fillings and extractions)
Major Services
(e.g., dentures, crowns, bridges,
wisdom teeth removal)
Orthodontia
Up to age 19
Your Cost
$50/individual
100% covered
You pay 20% of in-network
charges after deductible*
You pay 50% of in-network
charges after deductible*
No deductible
50% of in-network charges
Lifetime maximum
paid by plan: $1,500
UHC Dental Provider
myuhc.com
800-903-0989 Weekly Cost
Team Member
only
Team Member
+ Child(ren)
Team Member
+ Spouse
Family
Weely Cost of Dental Coverage
$6.40 $11.77 $11.77 $16.22
I busted a tooth and was in
a lot of pain. I went to the
dentist and they said that they
had to pull the tooth. With my
PFJ dental insurance, I was
able to get the tooth pulled for
only $70. Without insurance,
it would have cost me almost
$300. PFJ’s benefits really make
a better day for me!
Roque C.
myalex.com/pilotflyingj
*Maximum plan payout $1,500 per covered person / per year
/myuhc.com
/pilotflyingj