California Dental
Plan 595
California Dental Network, Inc. (CDN) combines comprehensive dental Coverage with a number of cost saving features for you and your family. Many preventive procedures are covered at no cost to you, and you will experience significant savings based upon our copayments for covered services. Plan features white fillings and implant benefits.
Plan 595 is the No Problem Plan:
- No Deductibles
- No Claim Forms
- No Annual Maximums
- No Limitations on Most Pre-Existing Conditions
- No Waiting Periods to See a Dentist
| Common procedures: | |
|---|---|
| Cleaning: | $0 |
| White Filling: | $14 |
| Crown: | $156* |
| Root Canals: | $80 |
| Simple Extractions: | $10 |
| Plan Maximum: | None |
| Waiting Periods: | None |
| Deductible: | None |
| Details: |
|---|
| Fee Schedule | Dentist Search | Exams: |
| No charge | Cleanings: |
| No charge – once every 6 months, covered only at the General Dentist’s Office | X-Rays: |
| No charge | Fillings: |
| $4 for Amalgam filling-one surface, primary or permanent $14 for (white filling) Resin-based composite-one surface, anterior $18 for Resin-based composite-one surface, posterior Covered for Facial surfaces of Bicuspids Only, when Caries or Failing Restoration Exists | Extractions: |
| $10 for (Simple) Extraction, erupted tooth or exposed root $30 for Surgical removal of erupted tooth $75 for Removal of impacted tooth-completely bony | Crowns: |
| $156* for Crown porcelain fused to noble metal *Additional lab fees apply. Lab fees range from $200 - $250 | Root Canals: |
| $80 for root canal-anterior per tooth $100 for root canal-premolar, per tooth $140 for root canal-molar tooth, per tooth | Dentures: |
| $160 for complete upper denture $160 for complete lower denture Replacements limited to every five years | Deep Cleanings: |
| $15 for Periodontal maintenance – once every 6 months $40 for Periodontal scaling and root planning-four or more teeth per quadrant, covered when performed by primary general dentist | Implants: |
| $1500 for surgical placement of implant body, endosteal: includes cost of, and placement of, healing cap when indicated Covered only when performed by Member’s assigned Participating General Dentist See plan brochure for complete details | Braces/Orthodontia: |
| $1695 for Comprehensive orthodontic treatment of the adolescent dentition $1695 for Comprehensive orthodontic treatment of the adult dentition Covered for up to 24 months of active treatment only when provided by participating orthodontist | Teeth Whitening: |
| $250 per arch for external bleaching, performed in office $125 per arch for external bleaching, for home application | Additional Network Information: |
You may select any CDN Participating Dentist for you and your family’s dental care. All family members MUST use the same office and the Plan subscriber must live or work within CDN’s service area within California. Exclusions and LimitationsPrivacy Policy Plan Brochure | Notes: |
*Additional lab fees apply |
FAQ:
Can I change my dentist once I am in the plan?
A request to change dental office may be done by contacting California Dental Network (CDN) toll‐free at 1‐877‐433‐6825 or by requesting such in writing to CDN’s office. Any such change will become effective on the first day of the month following CDN’s approval if request is received by CDN by the 20th of the month. CDN may require up to 30 days to process any such request. All Member fees and Copayments must be paid in full prior to such a transfer
What is a pre-existing condition versus work-in-progress? Is it covered?
A pre-existing condition is an oral health condition, which existed before your enrollment in a dental program. The plan does not include an exclusion for pre-existing conditions.
Work in progress is any oral health procedure that is started and not completed prior to your enrollment in a dental program. The plan does not cover any expenses prior to the date you are covered under the Policy.
What provider options do I have?
You may select any California Dental Network (CDN) Participating Dentist for you and your family’s dental care. All family members MUST use the same office and the Plan subscriber must live or work within CDN’s service area within California.
When can I start using my Plan?
You can start using your plan once it goes into effect - usually the 1st of the month following your enrollment (as long as the enrollment and payment is received within the enrollment deadline). Incomplete enrollment forms or failure to submit the required initial premium amount may cause an initial delay in issuance of insurance. Do not cancel any other insurance or assume you are insured under the Plan until you receive your certificate of insurance.
When will I receive my new member kit and what will it include?
You can expect to receive your membership packet and I.D. card by USPS within two weeks. You packet should include: ID cards, Evidence of Coverage (EOC), benefit summary, Non-discriminatory Notice, “Happy Smile” brochure, and if applicable, “Find a Dentist on-line” flyer.
Who can enroll in this plan?
Subscribers and eligible Dependents must either live or work within the California Dental Network approved service area to be eligible for Benefits under this plan. When payment and application are received and approved by the 20th of the month, eligibility will commence on the first of the following month.
23291 Mill Creek Dr. Ste 100
Laguna Hills, CA 92653
Disclaimers and Disclosures:
California Dental Network is part of the DentaQuest family of companies. With more than 50 years of experience, DentaQuest administers dental and vision benefits for 24 million members across 28 states and partners with more than 100 health plans.
California Dental is licensed by the California Department of Managed Health Care under the Knox-Keene Health Care Service Plan Act, which is one of the most comprehensive regulatory programs in the United States. Information about the Department of Managed Health Care and the plans they regulate can be found on their website at www.dmhc.ca.gov.
This website provides a very brief description of some of the important features of this plan. It is not the insurance contract, nor does it represent the insurance contract. A full description of benefits, exclusions and limitations is contained in the Schedule of Benefits and your policy.
Rates shown are based upon the information you provided, and are subject to change based on the dental and/or vision plan's underwriting practices and your selection of available optional benefits, if any. Final rates and effective dates are subject to underwriting and are always determined by the dental insurance and/or vision insurance company. To be considered for reimbursement, expenses must qualify as covered expenses.
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