Retiree Dental Plan

This plan is great for my husband and me.
Being on a fixed income, it is important that we know the costs of our dental services up front. With this plan we can get the services we need, when we need them. We can do regular cleanings a price we can afford, with no surprises. That is what we like the most. The plan is straightforward, easy to use, and easy to understand.

Finally, a plan with REAL discounts!
This plan works for me because I can use it as often as I like or just for cleanings and exams. Then if I need unplanned dental work, this plan helps minimize my dental expenses. I may be retired now, but I live a healthy life and know maintaining good oral health is an important part of that.

Summary of Discounts

ADA Code Diagnostic & Preventative You Pay
D0150 Comprehensive oral evaluation $30.50
D0120 Periodic oral evaluation $30.50
D0210 Intraoral - complete series of radiographic images $58.00
D0220 Intraoral - periapical first radiographic image $16.00
D0230 Intraoral - periapical each additional radiographic image $15.00
D0330 Panoramic radiographic image $50.00
D1110 Prophylaxis (Cleaning) Adult $46.00
D1120 Prophylaxis (Cleaning) Child $46.00
D1351 Sealant - per tooth $19.00
D1208 Topical application of fluoride $18.00
ADA Code Restorative You Pay
Resin-based composite-anterior
D2330 One surface $69.50
D2331 Two surfaces $105.00
D2332 Three surfaces $116.00
D2335 Four or more surfaces $116.00
Resin-based composite-posterior
D2391 One surface $93.00
D2392 Two surfaces $116.00
D2393 Three surfaces $139.00
D2393 Four or more surfaces $139.00
ADA Code Crowns You Pay
D2740 Crown – porcelain/ceramic substrate $678.00
D2750 Crown - porcelain fused to high noble metal $556.50
D2950 Core buildup $73.80
ADA Code Endodontics You Pay
D3220 Therapeutic pulpotomy $69.00
D3310 Root canal (anterior) $329.00
D3320 Root canal (bicuspid) $392.50
D3330 Root canal (molar) $472.00
ADA Code Periodontics You Pay
D4342 Periodontal scaling and root planning (one to three teeth per quadrant) $51.00
D4341 Periodontal scaling and root planning (four or more teeth per quadrant) $102.00
ADA Code Prosthodontics You Pay
Removable
D5110 Complete denture - maxillary (upper) $649.50
D5120 Complete denture - mandibular (lower) $649.50
D5213 Maxillary partial denture (upper) - cast metal framework with resin denture bases $950.00
D5214 Mandibular partial denture (lower) - cast metal framework with resin denture bases $950.00
Bridge
D6740 Crown – porcelain/ceramic substrate(per unit) $678.00
D6750 Crown - porcelain fused to high noble metal (per unit) $750.00
ADA Code Oral Surgery You Pay
D7111 Extraction, coronal remnants - deciduous tooth $80.00
D7140 Extraction, erupted tooth or exposed root $74.00
D7210 Surgical removal of erupted tooth $119.00
D7220 Removal of impacted tooth- Soft tissue $134.00
D7230 Removal of impacted tooth- Partially Bony $160.00
D7240 Removal of impacted tooth- Completely Bony $172.50