Plan Information

Plan Features

Renaissance Dental Max Choice Plan

This is a PPO (PPO MAC) plan. Plan participants have access to over 200,000 nationally credentialed dental PPO provider access points.
Individuals may visit any dentist, but will receive the best benefits by seeing a dentist who participates in the Renaissance PPO network. Individual claims will be paid based on Renaissance Dental’s PPO Fee Schedule. This means individuals seeking the lowest out-of-pocket costs should visit a PPO dentist.
No waiting periods on any services..

Max Choice Plan Fee Schedule

*When visiting a PPO dentist. Out-of-network fees are paid based on PPO Fee Schedule

Billing and eligibility administration provided by Morgan-White Administrators, Inc.

Covered Services Plan Pays
Year 1 Year 2 Year 3
Diagnostic & Preventive Services Used to evaluate existing conditions and/or to prevent dental abnormalities or disease (includes exams and cleanings) 100% 100% 100%
Basic Procedures:
  • Emergency palliative treatment - Used to temporarily relieve pain
  • Bitewing Radiographs- bitewing X-rays
  • Fluoride Treatment- topical application of fluoride
  • Periodontal Maintenance - Periodontal maintenance following active periodontal therapy
40% 60% 80%
  • Minor Restorative Services - Used to repair teeth damaged by disease or injury (for example, silver fillings and white fillings )
20% 40% 50%
Major Procedures:
  • Oral Surgery Services - Extractions and dental surgery, including local anesthesia, suturing, if needed, and routine post-operative care, services for the diagnosis and treatment of temporomandibular disorders
  • Endodontic Services - Used to treat teeth with diseased or damaged nerves (for example, root canals)
  • Periodontic Services - Used to treat diseases of the gums and supporting structures of the teet
  • Major Restorative Services - Used when teeth can't be restored with another filling material (for example, crowns)
  • Prosthodontic Services - Used to replace missing natural teeth (for example, bridges and dentures, and certain implant services)
  • Relines and Repairs - Relines and repairs to bridges, removable bridges, partial dentures, and complete dentures
  • Occlusal Guards - Benefits for occlusal guards, and limited occlusal adjustments
20% 40% 50%
Orthodontia Procedures:
($1,200 lifetime maximum per person for this benefit)
Orthodontic benefits are only available for eligible dependent children up to age 19. 10% 25% 50%

Annual Deductible per person/family for Basic and Major Services Only.

The Deductible does not apply for Diagnostic and Preventive or Orthodontic Services.

$50/$150 $50/$150 $50/$150
Annual Maximum $1,200 $1,200 $1,200