Dental Comparison

Meritain Health

D100/50/50 (maximum yearly coverage of $1,000 per person) $50 applied to any Class II or Class III Service Class I (preventative)

 

Class II (basic)

 

Class III (major)
100%

 

50%

 

50%
D100/75/50/50 (maximum yearly coverage of $1,500 per person) No Deductible Class I (preventative)

 

Class II (basic)

 

Class III (major)

 

Class IV (orthodontia)
100%

 

75%

 

50%

 

50%
Benefit MERITAIN HEALTH
D100/50/50
MERITAIN HEALTH
D100/75/50/50
Class I (Preventative Services) 100% of Customary Reasonable Fee 100% of Customary Reasonable Fee
Diagnostic Services oral exams, 2 within a plan year
- bitewing radiographs (x-rays) 2 within a plan year
- full-mouth radiographs, every 36 months
- other tests and lab exams
Covered Covered
Preventative Services - cleaning, 2 within the 12 month plan year
- fluoride
- space maintainers, under age 19
- dental sealant (for permanent first and second molars. One application once every five years for under age 20 years)
Covered Covered
Palliative Treatment
- emergency treatment for the temporary relief of dental pain
Covered Covered
Class II (Basic Services) 50% of Customary Reasonable Fee after annual deductible 75% of Customary Reasonable Fee
Restorative Services
- fillings, every 24 months
- new inlays, onlays and crowns. Repair or restoration of inlays, onlays, crowns already in place
- biopsy
Covered Covered
Endodontic Service
- pulp capping
- pulpotomy
- root canal therapy
- periapical treatment
Covered Covered
Oral Surgery
- simple and surgical extractions
- surgery of tooth socket
- surgery of the soft tissue areas of the mouth
- incision and drainage of intraoral abscess
Covered Covered
Basic Prosthodontic Services Covered Covered
Adjunctive General
- general anesthesia and desensitizing medications
- professional visits after office hours
Covered Covered
Class III (Major) Services 50% of Customary Reasonable Fee after annual deductible 50% of Customary Reasonable Fee
Extended Prosthodontic Services
- removable dentures
- fixed bridges
- bridge pontics (artificial teeth)
- abutment crowns for bridge construction
- dental implants - performed in a dental office.
(Bridge procedures codes D06720 through D06792 for the same tooth as the implant are excluded).
Covered Covered
Class IV (Orthodontic) Services 19 years or younger Not Covered 50% of Customary Reasonable Fee
Orthodontic Services
- appliance construction and installation
- minor tooth guidance appliances
- full-banding treatment
- monthly, active treatment visits
- habit-breaking appliances
Not Covered Covered Lifetime maximum: $2,000 per member up to age 19. If started before 19 years of age, they will pay until maximum is met, or until treatment plan is done.

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On-line services for members

Meritain Health
P.O. Box 30126
Lansing, MI 48909-7632
1-800-748-0003


Central Michigan University • 1200 S. Franklin St. • Mount Pleasant, Mich. 48859 • 989-774-4000