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Momentum Dental Insurance Plans - 3 easy options:

DHA Madison
EXCLUSIVE(7 Madison area locations Single Plan 
$20.00/MO DHA Madison Limited Network

$0 deductible

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COVERS 100% / YR
  • 2 cleanings (incl. exams)
  • 1 emergency visit
  • 1 set of bitewing x-rays
  • Fluoride treatment (up to 19 yrs. old)
Individual Plan
$34.11 / $40.11 /MO DHA Madison / Extended Network
Family Plan
$112.11 / $134.11 /MO DHA Madison / Extended Network

$50 deductible ($150 per family)

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COVERS 80% / YR
  • 2 cleanings (incl. exams)
  • 1 emergency visit
  • 1 set of bitewing x-rays
  • Fluoride treatment (through age 19)
  • Panoramic x-ray (once every 5 yrs.)
  • Sealants (through age 13)

AND COVERS

  • 80% diagnostic services (no waiting)
  • 80% preventative services (no waiting)
  • 60% basic restorative services*
  • 50% other services*
  • * waiting periods may apply
  • annual maximum benefit: $1,200
Individual Plan
$39.78 / $47.11 /MO DHA Madison / Extended Network
Family Plan
$133.11 / $154.11 /MO DHA Madison / Extended Network

$50 deductible ($150 per family)

waived for preventative and diagnostic

COVERS 100% / YR
  • 2 cleanings (incl. exams)
  • 1 emergency visit
  • 1 set of bitewing x-rays
  • Fluoride treatment (through age 19)
  • Panoramic x-ray (once every 5 yrs.)
  • Sealants (through age 13)

AND COVERS

  • 100% diagnostic services (no waiting)
  • 100% preventative services (no waiting)
  • 75% basic restorative services*
  • 50% other services*
  • * waiting periods may apply
  • annual maximum benefit: $1,200


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