Compare plans and make an educated choice about your PPO or Prepaid Dental Plan

PPO Plan Analysis
PUD and Blue Cross

	Blue Cross Plan		PUD Option 1
Calendar Year Maximum	$1000		$1500
Calendar Year Deductible	In or Out - $50/150		In - $50/150 Out - $75/225
Predetermination of benefits	$350		None required
	IN	OUT	IN	OUT
Diagnostic	80%	80%	100%	80%
Preventative	80%	80%	100%	80%
Restorative (fillings)	80%	80%	80%	80%
Endodontics (root canals)	60%	60%	80%	80%
Periodontics (gum surgery)	60%	60%	80%	80%
Oral Surgery	50%	50%	50%	50%
Prosthodontics	50%	50%	50%	50%
Orthodontia	None		50%	50%
Orth Lifetime Max			$1500	$1500
Orth Deductible			$50	$75
Premiums
	Blue Cross Plan 1000		PUD Option 1
	Current & Renewal Rate
	35.96		35.42
	67.81		69.60
	88.47		94.23

Procedure	New PMI Plan 506	PUD Napa Plan	PUD Imperial Plan
Office Visit	NC	NC	NC
Cleanings	NC	NC	NC
X-rays	NC	NC	NC
Sealants	$5.00	$5.00	$5.00
Amalgams	NC	NC	NC
Space Maintainers	$15.00	NC	NC
Extractions	NC	NC	NC
Wisdom Teeth Extractions	$30-$40	$17-$30	NC
Perio Scalings	NC	NC	NC
Root Canals	$30-$90	$0-$60	NC
Dentures	$75-$90	$93	NC
Crowns	$60	$58-$73	NC
Orthodontia	$1600 child	$1700 for child or adult	$1700 for child or adult
	$1800 adult	$400 start up fees	$400 start up fees
	$350 start up fees

Active (Current)	Active (New)	Retiree (Current)	Retiree (New)	PUD Actives & Retirees	PUD Actives & Retirees
$20.21	$21.42	$23.63	$25.05	$18.86	$23.39
$33.48	$35.49	$39.11	$41.46	$30.19	$37.42
$46.96	$49.78	$57.60	$61.06	$46.22	$57.31

NC - No Cost to Member
Please refer to the Napa/Imperial Schedule of Benefits for a complete listing of procedures.

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