1 As of 2/2012, Dental Benefit Provider’s, Inc. Network availability may vary by state, and a specific dental care provider’s contract status can change at any time. Therefore, before you receive care, it is recommended that you verify with the dental care provider that he or she is still contracted with the network. 2 Benefits for in- and out-of-network providers are different. For costs, benefits, exclusions, limitations, eligibility, and renewal terms call (800) 944-4699. Policy Forms GRI-DEN1, -01, -02, -03, -04, -05, -06, -07, -08, -12, -13, -14, -15, -16, -17, -19, -23, -24, -25, -26, -27, -29, -30, -32, -34, -35, -37, -39R, -40, -41, -42, -43, -47, -49 and GRI-DEN2-09. 3 After a $50 deductible In-Network Preventive Services are covered 100% with no waiting period: cleanings, x-rays. Basic Services are covered at 80% with a six-month waiting period: fillings, exams. Major Services are covered at 50% with a 12-month waiting period: root canals, dentures.
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