About this plan

This pediatric dental plan is for members who are 18 or younger when the plan starts. It provides access to care from more than 3,600 Tier 1 PPO dentists in Michigan, and thousands more nationwide. This plan also gives you the choice to see out-of-network dentists, but you pay more out of pocket.

You can buy this plan if you live in any Michigan county.

PPO. For dental care, you can go to any licensed dentist and this plan will share the cost. But you'll pay less if you see a Tier 1 PPO in-network dentist.

To give you an accurate price, we'll need some information. Find a plan to get a quote.

Class I services have no deductible. There is a deductible for Class II and III services only. Class IV services are not covered.

Your deductible is the amount you pay for dental services each year before your insurance begins to pay.

Your coinsurance is your share of the costs of a service. It's usually figured as a percentage of the amount we allow to be charged for services. You start paying coinsurance after you’ve met your plan’s deductible.

This out-of-pocket maximum is the most you’ll have to pay during a calendar year for covered pediatric dental services. Once you’ve reached this out-of-pocket maximum, your plan pays 100 percent of the allowed amount.

Members can find information about agent commissions.

Children can get pediatric benefits until the end of the calendar year in which they turn 19. There is no waiting period for pediatric dental.

For dental care, you can go to any licensed dentist and this plan will share the cost. But you'll pay less if you see a Tier 1 PPO in-network dentist.

Preventive care like exams and cleanings. There is no waiting period for Class I services.

Dental exams
Visits are covered twice a year.

Teeth cleaning (prophylaxis)
Cleanings are covered three times a year.

Bitewing X-rays
A set of four films is covered once a year.

Fluoride treatments
Fluoride treatments are covered twice a year for members to the end of the month of their 19th birthday.

Basic services like fillings and root canals.

Sealants
Sealants are covered once per fully erupted first and second permanent molar every 36 months for members to the end of the month of their 16th birthday.

Space maintainers
Space maintainers are covered once per quadrant every two years for members to the end of the month of their 15th birthday.

Periodontal maintenance
Limited to three times a year in combination with routine cleaning.

Fillings
Limited to once per tooth and surface every 24 months for primary teeth, and once per tooth and surface every 48 months for permanent teeth.

Simple extractions

Root canals
Covered once per tooth per lifetime

Major services like crowns and bridges. 

Oral surgery
This includes all oral surgery except simple extractions, which are covered in Class II.

Crowns, onlays, veneer fillings
Covered once per tooth every 60 months.

Bridges and dentures

Complete dentures covered once per arch every 84 months; partial dentures and bridges covered once per arch every 84 months for members age 16 and older.

Implants
Not covered

Orthodontic services
Not covered