Dental PPO 0-20-50 1500
PacificSource Health Plans
High
- Ind. deductible
- —
- Family deductible
- —
- Ind. OOP max
- $450
- Family OOP max
- $450
Other cost-sharing reduction variants for this plan:
More PacificSource Health Plans plans in OR
Monthly premiums by age
| Age | Individual |
|---|---|
| 21 | $48 |
| 30 | $55 |
| 40 | $65 |
| 50 | $72 |
| 60 | $79 |
Live premium estimate
Benefits & cost sharing
Other
| 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 |
Plan rules
Service area
This plan covers 1 geographic area.