- More than 3,400 dentists throughout Maryland, DC and Northern Virginia
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In-NetworkAs a member you’ll receive 100 % coverage in network for preventive and diagnostic services. Individual Select Preferred combines the freedom to select any dentist from our large regional network with wide-ranging coverage of preventive and diagnostic dental services.
The following are some of the services which are covered in full when visiting an in-network provider:
- Examinations
- Cleanings
- X-rays
- Sealants
- Fluoride treatments for children
Participating dentists accept 100 % of the Allowed
Benefit* from CareFirst as payment in full for
covered services.
Dental Service
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Regular Cost of Dental Services*
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Individual Select PreferredYou Pay
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Biannual Checkups(twice a year) including routine exams, cleanings and x-rays
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$330* (2 visits per year)
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No charge in-network
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Out-of-Network
You also have the option to seek routine preventive
and diagnostic treatment from Non-Participating
Providers. If you visit a Non-participating Provider,
CareFirst will still pay the Allowed Benefit, but
you will be responsible for the difference in cost
between the CareFirst Allowed benefit and your
dental provider’s full charge.
Please see the brochure for details of the benefits
* Based on 2012 National Dental Advisory Service Fee Report.
Allowed Benefit*
The Allowed Benefit is typically a reduced rate
rather than the actual charge. For example: You
have just visited your dentist for a routine exam
and cleaning. The total charge for the visit comes
to $125. If the doctor is a participating provider
they may be required to accept $75 from CareFirst
as payment in full for the visit—this is the Allowed
Benefit. If, however, the dental provider you visit is
non-participating then you may be held
responsible for the difference between the
CareFirst Allowed Benefit and the Dental
Provider’s full charge.
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APPLICATION FORM -DC-Individual Select PPO Dental Plan BROCHURE -DC-Individual Select PPO Dental Plan DC-ISP-PPO-Rates
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-Lower cost - More than 800 dentists throughout Maryland, DC and Northern Virginia |
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Dental Service
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Regular Cost of Dental Services*
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Individual Select Dental HMOYou Pay
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BiannualCheckups(twice a year) including routine exams, cleanings and x-rays
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$225 (2 visits per year)
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$20 per office visit copay
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SimpleToothExtractions
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$135
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$20 per office visit copay
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PeriodontalScalingandRootPlaning(four or more teeth per section of the mouth)
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$210
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$70 per office visit copay
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PorcelainCrown(high noble metal)
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$915
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$460
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CompleteUpperDentures
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$1,375 each
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$495 each
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Orthodontics (braces)
Adolescents
Adults
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$4,890
$5,110
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$2,500
$2,700
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