HMSA
| Age | Individual |
|---|---|
| 21 | $23 |
| 30 | $23 |
| 40 | $23 |
| 50 | $23 |
| 60 | $23 |
| Benefit | In-network |
|---|---|
| Accidental Dental | Not covered |
| Basic Dental Care - Adult | $40.00 |
| Basic Dental Care - Child | $40.00 |
| Dental Check-Up for Children | $10.00 |
| Major Dental Care - Adult | $250.00 |
| Major Dental Care - Child | $250.00 |
| Orthodontia - Adult | Not covered |
| Orthodontia - Child | 50.00% |
| Routine Dental Services (Adult) | $10.00 |
This plan covers 1 geographic area.