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Dental - Compare Options

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This Dental Plan Comparison Chart includes the coverage levels for commonly used services. This comparison chart does not reflect all dental plan services, exclusions, limitations, or restrictions. It is not considered a contract or guarantee of coverage under the Plans. Refer to the Summary Plan Document located at www.oraclebenefits.com for more details on Plan provisions and limitations.

Select up to 2 plans to compare

Dental Plan 1 (No Cost)
MetLife
Dental Plan 2
MetLife
Calendar Year Deductible
Network: $50 per individual/ $150 family
Non-Network: $50 per individual/ $150 family
Network: $50 per individual/ $150 family
Non-Network: $50 per individual/ $150 family
Calendar Year Benefit Maximum
Network: $2,500
Non-Network: $2,500
Network: $2,500
Non-Network: $2,500
Orthodontia Lifetime Benefit Maximum
Network: Not Covered
Non-Network: Not Covered
Network: $2,500
Non-Network: $2,500
Preventive Care Coinsurance
Network: 100% (No Deductible)
Non-Network: 100% (No Deductible)
Network: 100% (No Deductible)
Non-Network: 100% (No Deductible)
Basic Care Coinsurance
Network: 80% (After Deductible)
Non-Network: 80% (After Deductible)
Network: 80% (After Deductible)
Non-Network: 80% (After Deductible)
Major Care Coinsurance
Network: 50% (After Deductible)
Non-Network: 50% (After Deductible)
Network: 80% (After Deductible)
Non-Network: 80% (After Deductible)
Orthodontia Coinsurance
Network: Not Covered
Non-Network: Not Covered
Network: 50% (No Deductible)
Non-Network: 50% (No Deductible)
Preventive Dental Services
Cleaning/Polishing
Network: 100%
Non-Network: 100% (of UCR)
Network: 100%
Non-Network: 100% (of UCR)
Fluoride Treatments
Network: 100%
Non-Network: 100% (of UCR) 1
Network: 100%
Non-Network: 100% (of UCR) 1
Sealants
Network: 100%
Non-Network: 100% (of UCR) 1
Network: 100%
Non-Network: 100% (of UCR) 1
X-Rays
Network: 100%
Non-Network: 100% (of UCR)
Network: 100%
Non-Network: 100% (of UCR)
Exams
Network: 100%
Non-Network: 100% (of UCR)
Network: 100%
Non-Network: 100% (of UCR)
Basic Services
Fillings
Network: 80% after deductible
Non-Network: 80% (of UCR) after deductible 5
Network: 80% after deductible
Non-Network: 80% (of UCR) after deductible 5
Periodontal Services
Network: 80% after deductible
Non-Network: 80% (of UCR) after deductible
Network: 80% after deductible
Non-Network: 80% (of UCR) after deductible
General Anesthetics
Network: 80% after deductible
Non-Network: 80% (of UCR) after deductible 2
Network: 80% after deductible
Non-Network: 80% (of UCR) after deductible 2
Root Canal Therapy
Network: 80% after deductible
Non-Network: 80% (of UCR) after deductible
Network: 80% after deductible
Non-Network: 80% (of UCR) after deductible
Repair/Maintain Major Service
Network: 80% after deductible
Non-Network: 80% (of UCR) after deductible
Network: 80% after deductible
Non-Network: 80% (of UCR) after deductible
Major Services
Inlays, onlays, crowns, bridges, implants
Network: 50% after deductible
Non-Network: 50% (of UCR) after deductible 3 5
Network: 80% after deductible
Non-Network: 80% (of UCR) after deductible 3 5
Removable Dentures
Network: 50% after deductible
Non-Network: 50% (of UCR) after deductible 3
Network: 80% after deductible
Non-Network: 80% (of UCR) after deductible 3
Orthodontia Services
Services and Supplies
Network: Not Covered
Non-Network: Not Covered
Network: 50%
Non-Network: 50% (of UCR)
Diagnostic Procedures
Network: Not Covered
Non-Network: Not Covered
Network: 50%
Non-Network: 50% (of UCR)
Surgery
Network: Not Covered
Non-Network: Not Covered
Network: 50%
Non-Network: 50% (of UCR)
Appliances
Network: Not Covered
Non-Network: Not Covered
Network: 50%
Non-Network: 50% (of UCR) 4

This Dental Plan Comparison includes the coverage levels for commonly used services. This comparison chart does not reflect all dental plan services, exclusions, limitations, or restrictions. It is not considered a contract or guarantee of coverage under Plans. Refer to the Summary Plan Document located at www.oraclebenefits.com for more details on Plan provisions and limitations.


1 Fluoride and sealant treatments are limited to children to the age of 19 years old. Effective 01/01/2023: Sealants will be limited to one every 36 months upto age of 19, Fluoride will be limited to two every calendar year upto age of 19.
2 General Anesthetics is covered when given in connection with oral surgery or other covered dental services when medically necessary.
3 Limited to once every 5 years.
4 Lost, missing, stolen appliances - not covered. .
5 Composite filings and porcelain crowns will be covered 01/01/2023 with no alternate.
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