Certified Optimum Coverage (add-on)

Certified Optimum Coverage is a way to get the best out of your pediatric benefits.

Certified Optimum Coverage Rider, when added to a traditional PPO plan, provides the greater benefit from either the traditional or additional coverage for all members under the age of 19 (pediatric).

 

Certified Optimum Coverage Access

When you have Certified Optimum Coverage you receive care from your normal dentist. This benefit simply provides the member the ability to receive the highest coinsurance and lowest individual deductible combination for specific services covered under the plans. Because this benefit requires a PPO plan, your access to our vast network of dentist and specialist is based off of your traditional Plan design.

 

Features:

  • Rider provides the highest coinsurance and lowest individual deductible combination for covered services
  • Waiting period for Medically Necessary Orthodontics is waived for groups who currently purchase Cosmetic Orthodontics

 

Benefits:

  • Causes virtually no disruption to current benefits or network
  • Limits out of pocket expenses for enrolled pediatric dependents
  • Can be added to any standalone PPO Dental plan
  • Maximum out of pocket cost per child is $350 or $700 max for multiple children under the age of 19
  • Adult members can continue with their same plan coverage while compliance is met for those under the age of 19
  • Can be added to any standalone PPO Dental plan
  • Can be used to provide reasonable assurance to a medical carrier