PacificSource Health Plans
Other cost-sharing reduction variants for this plan:
| Age | Individual |
|---|---|
| 21 | $40 |
| 30 | $46 |
| 40 | $55 |
| 50 | $60 |
| 60 | $66 |
| Benefit | In-network |
|---|---|
| Accidental Dental | 50.00% |
| Basic Dental Care - Adult | 20.00% |
| Basic Dental Care - Child | 20.00% |
| Dental Check-Up for Children | No charge |
| Major Dental Care - Adult | 50.00% |
| Major Dental Care - Child | 50.00% |
| Orthodontia - Adult | Not covered |
| Orthodontia - Child | 50.00% |
| Routine Dental Services (Adult) | No charge |
This plan covers 1 geographic area.