Benefit Comparison3 | UNITED SILVER (PLAN 1) |
UNITED GOLD (PLAN 2) |
---|---|---|
Policy Year Maximum Benefit | $1,000 | $1,000 or $2,000 (choose one) |
Policy Year Deductible | $0 | $0 |
Dental Coverage | ||
Preventive Services4 Examination, cleaning and routine X-Ray2 3 month waiting period |
After 90 Days - Up To $125 After 12 Months (and thereafter) 1st Visit Up To $125, 2nd Visit Up To $75 (per policy year) | After 90 Days - Up To $125 After 12 Months (and thereafter) 1st Visit Up To $125, 2nd Visit Up To $75 (per policy year) |
Basic Services Including X-Ray, fillings and extractions2 No waiting period |
Immediately - 70% After 12 Months - 80% After 24 Months - 80% After 36 Months - 90% (and thereafter) |
Immediately - 60% After 12 Months - 70% After 24 Months - 80% After 36 Months - 90% (and thereafter) |
Major Services Including bridges, crowns, full dentures or partials, full mouth extractions, and root canals2 12 month waiting period |
Not Covered |
After 12 Months - 70% After 24 Months - 80% After 36 Months - 90% (and thereafter) |
Vision Coverage (not available in Colorado) | ||
Basic eye examination or eye refraction, including the cost of eye glasses or contact lenses2 | $150 (per 24 month period) |
$150 (per 24 month period) |
Waiting Period | Exam, first time corrective lenses No Waiting Period Repair or replacement of existing eye glasses or contact lenses 6 months |
Exam, first time corrective lenses No Waiting Period Repair or replacement of existing eye glasses or contact lenses 6 months |
1 | Benefits are not subject to assignment. |
2 | Services performed or prescribed by a licensed Medical Professional not a member of your immediate family. |
3 | Refer to your policy for a complete description of limitations and exclusions. |
4 | This benefit is included in the Policy Year Maximum Benefit. Only the $125 benefit is available in the first policy year. |