DENTAL BENEFITS INFORMATION

Please refer to your 2022 Evidence of Coverage (EOC) for details about your dental benefits provided through DentaQuest. 

General Benefits 

Plans have a generous benefit allowance. 

Coverage includes a first-dollar benefit allowance for services – no deductible: 

Our plans have a low 30% coinsurance on some services. You pay the amount that exceeds your plan allowance. 

Preventive dental services 

• Cleaning 

• Dental x-ray(s) 
• Oral exam 
• Fluoride treatment 

Comprehensive dental services (Non-preventive) 

• Restorative services (such as fillings) 

• Periodontics (such as scaling and root planing) 
• Extractions 

A specific code list is available in Chapter 4 of your Evidence of Coverage. 

Additional Questions/Find a Provider 

If you have additional questions, call DentaQuest Customer Service at 1-833-493-0566 (TTY: 711)

Find a network dentist using our provider search