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Procedures
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United Concordia
Pre-Paid Dental Plan available in California
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Important information about the Plan
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Each family member must select a participating United Concordia dentist from their provider directory, and have all dental services performed by that dentist. (Each family member can choose a different office.) If you go to a dentist other than your selected United Concordia network dentist, you and/or your denpendents will have no coverage for those services rendered, except for certain dental emergencies.
There are no claim forms to fill out, and the Trust Fund pays United Concordia directly for your dental care needs
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| Deductible |
None |
| Annual Maximum |
None
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| Diagnostic
Oral Examination, Full Mouth X-rays, Bitewing X-rays, Emergency treatment (during office hours)
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Plan pays 100% |
| Preventive
Prophylaxis, Topical fluoride, Sealants (per tooth), Space maintainers
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Plan pays 100% |
| Periodontic
Subgingival curettage, Gingivectomy, Muco-gingival or osseous surgery
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Plan pays 100% (except for bone grafts) |
Endodontic
- Pulp capping
- Pulptomy
- Root Canals
- Apicoectomy - per root
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- Plan pays 100%
- Plan pays 100%
- You pay $20 - $40
- Plan pays 100%
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| Restorative (other than crowns)
Amalgram - primary & permanent teeth
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Plan pays 100%
(white fillings on back teeth are considered cosmetic, and have co-pays)
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| Crowns and Bridges
Crowns per unit -
- Full gold
- Predominately base metal
- Porcelain
- Pin Build-up
- Post and core
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- You pay $40 plus cost of gold
- You pay $40
- You pay $40
- Plan pays 100%
- Plan pays 100%
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Prosthodontics
- Dentures - complete or partial
- Denture or Partial adjustments
- Denture reline (office)
- Denture rebase
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- You pay $25 - $63
- Plan pays 100%
- Plan pays 100%
- Plan pays 100%
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| Oral Surgery
Simple extractions, Surgical extractions Impactions, Frenectomy
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Plan pays 100% |
Orthodontia
- Full Banding
- Retention
- Records Fee
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- You pay $1,500 for under age 19, $2,000 for age 19 or older
- You pay $240
- You pay $265
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| Emergency Out-of-Area Treatment |
You will be reimbursed up to $100 per year, per person |
