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%|
($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.