Dental Standard Option 2021
No deductibles. No waiting periods.1
View the 2022 Standard Option Dental plan
Why you might like Standard Option:
- GEHA’s lowest premium dental plan.
- Includes $2,500 in-network annual maximum benefit per person.
- No waiting periods, except for orthodontic services.
To compare the Standard Option side by side with the High Option, click Choose & Compare Plans.
1 No waiting period for Class A, Class B or Class C services. 12-month waiting period for Class D orthodontic services, Standard Option plan only.
|2021 Plan Year Standard Option Benefit Schedule|
|What the plan pays||In-network or out-of-network1|
|Class A – Basic
Two exams, two cleanings and one X-ray per calendar year
|Class B – Intermediate
Fillings, extractions and periodontal maintenance
|Class C – Intermediate
Root canals, crowns, bridges, dentures, periodontal surgery (implants limited to $2,500 per person/year)
|Class D – Orthodontics
Adults and children
12-month waiting period
$2,500 lifetime maximum
|Calendar year maximum
for Class A, B and C services
|$2,500 per person|
1 There is no waiting period for Class A, Class B or Class C services. There is a 12-month waiting period for Class D orthodontic services on the Standard Option plan only.
2 If your out-of-network dentist charges more than GEHA’s agreed-upon plan allowance for a specific service, you are responsible for the difference between the plan allowance and the out-of-network dentist’s charge plus regular coinsurance.
Coordination of benefits – As with all FEDVIP plans, dental benefits available from your FEHB carrier will be considered before we calculate benefits paid by GEHA.
Orthodontic services – GEHA does not cover orthodontic services previously started with another carrier, except for High Option members with orthodontics started under TRICARE.
Choosing a dentist – You have the choice of providers. However, for many services, your out-of-pocket costs may be lower when you visit in-network locations. Network providers will not bill you more than the Plan's maximum allowable charge for covered services.
Claim forms – No special claim forms are required. Just send in the itemized bill from your provider.
Limitations and exclusions – This plan has certain limits on dental coverage in order to keep plan rates affordable for you and your dependents. A complete list of plan limitations and exclusions may be found in the Plan Brochure.
Included benefits & discounts
Hearing aid discount
Electric toothbrush discount
Teeth whitening discount
Medical alert system
1 The cariPRO™ premium toothbrush removes seven times more plaque than a regular brush, is completely waterproof and comes with a two-year manufacturer‘s warranty. Replacement brush heads with high-quality DuPont™ bristles are also available at this exclusive, member-only price.