
*Some Details May Vary – Please Refer to State Specific Guides*
Unique Plan Features:
- $25 Copay Per Visit
- In-Network Advantages including no claim forms!
- Basic, Intermediate and Major Services
- Issues ages 18-99 Individual, Spouse and Dependent Children
- Coverage for Implants
Rates for: AL, AZ, FL, ID, IA, KS, MS, OH, OK, PA