Healthy Kids

Dental & Vision

Dental Benefits

Dental Services are provided through Delta Dental to members under age 21 and pregnant women. Covers preventive, diagnostic and restorative services. Orthodontic services are not covered. For questions about coverage and for assistance in choosing a dentist, call Delta Dental at 1-866-527-9564.

Cost: $0 co-pay for annual dental check-up and restorative services (fillings) for all income categories.

Vision Benefits

Covers one comprehensive examination and one pair of eyeglasses (lenses and frames) in a 12-month period. Contact lenses are covered only as a substitute for eyeglasses, or if they are medically necessary.

Cost: A pair of eyeglasses are covered up to $75, and contacts with related services up to $110. Members are responsible for paying the difference when costs are higher.

Income CategoryCo-pay
Categories A & B$5 Co-pay
Categories C & D$10 Co-pay
Category E$10 Co-pay