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Dental Plans

Flexible Plan Pricing & Coverage

Find Your Perfect Coverage

How Many People Need Coverage?*
Choose a Network Option:*
- Dental Health Associates of Madison (7 Madison Area Locations)
- Commercial Network (1000+ In Network Locations)
MONTHLY PREMIUM

^$25

per month

Dental Health Associates of Madison Only

No Annual Maximum
$0

$0 DEDUCTIBLE

100% COVERAGE/YR

2 cleanings (every 6 mo.)

2 exams (every 6 mo.)

1 set of bitewing x-rays (once per year)

Fluoride treatment (through age 18)

1 Limited Evaluation

Courtesy Discount

10% Other Services**
**Only at Dental Health Associates of Madison Locations

Enrolling in this plan does not waive waiting periods for the Gold or Platinum plans.

ENROLL NOW
MONTHLY PREMIUM

^$37.75

per month

Dental Health Associates of Madison

member annual maximum benefit
$1,200

$50 Deductible / $150 Family

80% COVERAGE/YR

Applies to Preventive & Diagnostic

2 cleanings (every 6 mo.)

2 exams (every 6 mo.)

1 set of bitewing x-rays (once per year)

Fluoride treatment (through age 18)

Panoramic x-ray (once per 5 yr. period)

Sealants (through age 18)

ALSO COVERED

60% Basic Restorative coverage**
Fillings
Simple Extractions
50% Major Restorative coverage**
Crowns (excluding implant crowns)
Root Canals
Dentures / Bridges
Periodontics

** basic/6 mo. waiting period
**major/12 mo. waiting period

ENROLL NOW

**Waiting periods may be waived if you were covered under an employer-sponsored group policy within 60 days of the start of your coverage under this policy, or an individual policy within 30 days of the start of your coverage under this policy. Momentum Platinum and Gold Plans do not cover oral surgery, implants, implant related services, orthodontics or cosmetic services.
MONTHLY PREMIUM

^$44.25

per month

Dental Health Associates of Madison

member annual maximum benefit
$1,200

$50 Deductible / $150 Family

100% COVERAGE/YR

Waived for Preventive & Diagnostic

2 cleanings (every 6 mo.)

2 exams (every 6 mo.)

1 set of bitewing x-rays (once per year)

Fluoride treatment (through age 18)

Panoramic x-ray (once per 5 yr. period)

Sealants (through age 18)

ALSO COVERED

75% Basic Restorative coverage**

Fillings

Simple Extractions

50% Major Restorative coverage**

Crowns (excluding implant crowns)
Root Canals

Dentures / Bridges

Periodontics

** basic/6 mo. waiting period
**major/12 mo. waiting period

ENROLL NOW

**Waiting periods may be waived if you were covered under an employer-sponsored group policy within 60 days of the start of your coverage under this policy, or an individual policy within 30 days of the start of your coverage under this policy. Momentum Platinum and Gold Plans do not cover oral surgery, implants, implant related services, orthodontics or cosmetic services.
*Family rate is for 3-4 people. Please add an additional $25 per person for each additional member over 4.
MONTHLY PREMIUM

^$50

per month

Dental Health Associates of Madison Only

No Annual Maximum
$0

$0 DEDUCTIBLE

100% COVERAGE/YR

2 cleanings (every 6 mo.)

2 exams (every 6 mo.)

1 set of bitewing x-rays (once per year)

Fluoride treatment (through age 18)

1 Limited Evaluation

Courtesy Discount

10% Other Services**
**Only at Dental Health Associates of Madison Locations

Enrolling in this plan does not waive waiting periods for the Gold or Platinum plans.

ENROLL NOW
MONTHLY PREMIUM

^$75.50

per month

Dental Health Associates of Madison

member annual maximum benefit
$1,200

$50 Deductible / $150 Family

80% COVERAGE/YR

Applies to Preventive & Diagnostic

2 cleanings (every 6 mo.)

2 exams (every 6 mo.)

1 set of bitewing x-rays (once per year)

Fluoride treatment (through age 18)

Panoramic x-ray (once per 5 yr. period)

Sealants (through age 18)

ALSO COVERED

60% Basic Restorative coverage**
Fillings
Simple Extractions
50% Major Restorative coverage**
Crowns (excluding implant crowns)
Root Canals
Dentures / Bridges
Periodontics

** basic/6 mo. waiting period
**major/12 mo. waiting period

ENROLL NOW

**Waiting periods may be waived if you were covered under an employer-sponsored group policy within 60 days of the start of your coverage under this policy, or an individual policy within 30 days of the start of your coverage under this policy. Momentum Platinum and Gold Plans do not cover oral surgery, implants, implant related services, orthodontics or cosmetic services.
MONTHLY PREMIUM

^$88.50

per month

Dental Health Associates of Madison

member annual maximum benefit
$1,200

$50 Deductible / $150 Family

100% COVERAGE/YR

Waived for Preventive & Diagnostic

2 cleanings (every 6 mo.)

2 exams (every 6 mo.)

1 set of bitewing x-rays (once per year)

Fluoride treatment (through age 18)

Panoramic x-ray (once per 5 yr. period)

Sealants (through age 18)

ALSO COVERED

75% Basic Restorative coverage**

Fillings

Simple Extractions

50% Major Restorative coverage**

Crowns (excluding implant crowns)

Root Canals

Dentures / Bridges

Periodontics

** basic/6 mo. waiting period
**major/12 mo. waiting period

ENROLL NOW

**Waiting periods may be waived if you were covered under an employer-sponsored group policy within 60 days of the start of your coverage under this policy, or an individual policy within 30 days of the start of your coverage under this policy. Momentum Platinum and Gold Plans do not cover oral surgery, implants, implant related services, orthodontics or cosmetic services.
MONTHLY PREMIUM

^$75

per month

Dental Health Associates of Madison Only

No Annual Maximum
$0

$0 DEDUCTIBLE

100% COVERAGE/YR

2 cleanings (every 6 mo.)

2 exams (every 6 mo.)

1 set of bitewing x-rays (once per year)

Fluoride treatment (through age 18)

1 Limited Evaluation

Courtesy Discount

10% Other Services**
**Only at Dental Health Associates of Madison Locations

Enrolling in this plan does not waive waiting periods for the Gold or Platinum plans.

ENROLL NOW
MONTHLY PREMIUM

^$143.50

per month

Dental Health Associates of Madison

member annual maximum benefit
$1,200

$50 Deductible / $150 Family

80% COVERAGE/YR

Applies to Preventive & Diagnostic

2 cleanings (every 6 mo.)

2 exams (every 6 mo.)

1 set of bitewing x-rays (once per year)

Fluoride treatment (through age 18)

Panoramic x-ray (once per 5 yr. period)

Sealants (through age 18)

ALSO COVERED

60% Basic Restorative coverage**
Fillings
Simple Extractions
50% Major Restorative coverage**
Crowns (excluding implant crowns)
Root Canals
Dentures / Bridges
Periodontics

** basic/6 mo. waiting period
**major/12 mo. waiting period

ENROLL NOW

**Waiting periods may be waived if you were covered under an employer-sponsored group policy within 60 days of the start of your coverage under this policy, or an individual policy within 30 days of the start of your coverage under this policy. Momentum Platinum and Gold Plans do not cover oral surgery, implants, implant related services, orthodontics or cosmetic services.
MONTHLY PREMIUM

^$167.50

per month

Dental Health Associates of Madison

member annual maximum benefit
$1,200

$50 Deductible / $150 Family

100% COVERAGE/YR

Waived for Preventive & Diagnostic

2 cleanings (every 6 mo.)

2 exams (every 6 mo.)

1 set of bitewing x-rays (once per year)

Fluoride treatment (through age 18)

Panoramic x-ray (once per 5 yr. period)

Sealants (through age 18)

ALSO COVERED

75% Basic Restorative coverage**

Fillings

Simple Extractions

50% Major Restorative coverage**

Crowns (excluding implant crowns)

Root Canals

Dentures / Bridges

Periodontics

** basic/6 mo. waiting period
**major/12 mo. waiting period

ENROLL NOW

**Waiting periods may be waived if you were covered under an employer-sponsored group policy within 60 days of the start of your coverage under this policy, or an individual policy within 30 days of the start of your coverage under this policy. Momentum Platinum and Gold Plans do not cover oral surgery, implants, implant related services, orthodontics or cosmetic services.
MONTHLY PREMIUM

^$100

per month

Dental Health Associates of Madison Only

No Annual Maximum
$0

$0 DEDUCTIBLE

100% COVERAGE/YR

2 cleanings (every 6 mo.)

2 exams (every 6 mo.)

1 set of bitewing x-rays (once per year)

Fluoride treatment (through age 18)

1 Limited Evaluation

Courtesy Discount

10% Other Services**
**Only at Dental Health Associates of Madison Locations

Enrolling in this plan does not waive waiting periods for the Gold or Platinum plans.

ENROLL NOW
MONTHLY PREMIUM

^$143.50

per month

Dental Health Associates of Madison

member annual maximum benefit
$1,200

$50 Deductible / $150 Family

80% COVERAGE/YR

Applies to Preventive & Diagnostic

2 cleanings (every 6 mo.)

2 exams (every 6 mo.)

1 set of bitewing x-rays (once per year)

Fluoride treatment (through age 18)

Panoramic x-ray (once per 5 yr. period)

Sealants (through age 18)

ALSO COVERED

60% Basic Restorative coverage**
Fillings
Simple Extractions
50% Major Restorative coverage**
Crowns (excluding implant crowns)
Root Canals
Dentures / Bridges
Periodontics

** basic/6 mo. waiting period
**major/12 mo. waiting period

ENROLL NOW

**Waiting periods may be waived if you were covered under an employer-sponsored group policy within 60 days of the start of your coverage under this policy, or an individual policy within 30 days of the start of your coverage under this policy. Momentum Platinum and Gold Plans do not cover oral surgery, implants, implant related services, orthodontics or cosmetic services.
MONTHLY PREMIUM

^$167.50

per month

Dental Health Associates of Madison

member annual maximum benefit
$1,200

$50 Deductible / $150 Family

100% COVERAGE/YR

Waived for Preventive & Diagnostic

2 cleanings (every 6 mo.)

2 exams (every 6 mo.)

1 set of bitewing x-rays (once per year)

Fluoride treatment (through age 18)

Panoramic x-ray (once per 5 yr. period)

Sealants (through age 18)

ALSO COVERED

75% Basic Restorative coverage**

Fillings

Simple Extractions

50% Major Restorative coverage**

Crowns (excluding implant crowns)

Root Canals

Dentures / Bridges

Periodontics

** basic/6 mo. waiting period
**major/12 mo. waiting period

ENROLL NOW

**Waiting periods may be waived if you were covered under an employer-sponsored group policy within 60 days of the start of your coverage under this policy, or an individual policy within 30 days of the start of your coverage under this policy. Momentum Platinum and Gold Plans do not cover oral surgery, implants, implant related services, orthodontics or cosmetic services.
MONTHLY PREMIUM

^$125

per month

Dental Health Associates of Madison Only

No Annual Maximum
$0

$0 DEDUCTIBLE

100% COVERAGE/YR

2 cleanings (every 6 mo.)

2 exams (every 6 mo.)

1 set of bitewing x-rays (once per year)

Fluoride treatment (through age 18)

1 Limited Evaluation

Courtesy Discount

10% Other Services**
**Only at Dental Health Associates of Madison Locations

Enrolling in this plan does not waive waiting periods for the Gold or Platinum plans.

ENROLL NOW
MONTHLY PREMIUM

^$168.50

per month

Dental Health Associates of Madison

member annual maximum benefit
$1,200

$50 Deductible / $150 Family

80% COVERAGE/YR

Applies to Preventive & Diagnostic

2 cleanings (every 6 mo.)

2 exams (every 6 mo.)

1 set of bitewing x-rays (once per year)

Fluoride treatment (through age 18)

Panoramic x-ray (once per 5 yr. period)

Sealants (through age 18)

ALSO COVERED

60% Basic Restorative coverage**
Fillings
Simple Extractions
50% Major Restorative coverage**
Crowns
Root Canals
Dentures / Bridges
Periodontics

** basic/6 mo. waiting period
**major/12 mo. waiting period

ENROLL NOW

**Waiting periods may be waived if you were covered under an employer-sponsored group policy within 60 days of the start of your coverage under this policy, or an individual policy within 30 days of the start of your coverage under this policy. Momentum Platinum and Gold Plans do not cover oral surgery, implants, implant related services, orthodontics or cosmetic services.
MONTHLY PREMIUM

^$192.50

per month

Dental Health Associates of Madison

member annual maximum benefit
$1,200

$50 Deductible / $150 Family

100% COVERAGE/YR

Waived for Preventive & Diagnostic

2 cleanings (every 6 mo.)

2 exams (every 6 mo.)

1 set of bitewing x-rays (once per year)

Fluoride treatment (through age 18)

Panoramic x-ray (once per 5 yr. period)

Sealants (through age 18)

ALSO COVERED

75% Basic Restorative coverage**
Fillings
Simple Extractions
50% Major Restorative coverage**
Crowns
Root Canals
Dentures / Bridges
Periodontics

** basic/6 mo. waiting period
**major/12 mo. waiting period

ENROLL NOW

**Waiting periods may be waived if you were covered under an employer-sponsored group policy within 60 days of the start of your coverage under this policy, or an individual policy within 30 days of the start of your coverage under this policy. Momentum Platinum and Gold Plans do not cover oral surgery, implants, implant related services, orthodontics or cosmetic services.
MONTHLY PREMIUM

^$150

per month

Dental Health Associates of Madison Only

No Annual Maximum
$0

$0 DEDUCTIBLE

100% COVERAGE/YR

2 cleanings (every 6 mo.)

2 exams (every 6 mo.)

1 set of bitewing x-rays (once per year)

Fluoride treatment (through age 18)

1 Limited Evaluation

Courtesy Discount

10% Other Services**
**Only at Dental Health Associates of Madison Locations

Enrolling in this plan does not waive waiting periods for the Gold or Platinum plans.

ENROLL NOW
MONTHLY PREMIUM

^$193.50

per month

Dental Health Associates of Madison

member annual maximum benefit
$1,200

$50 Deductible / $150 Family

80% COVERAGE/YR

Applies to Preventive & Diagnostic

2 cleanings (every 6 mo.)

2 exams (every 6 mo.)

1 set of bitewing x-rays (once per year)

Fluoride treatment (through age 18)

Panoramic x-ray (once per 5 yr. period)

Sealants (through age 18)

ALSO COVERED

60% Basic Restorative coverage**
Fillings
Simple Extractions
50% Major Restorative coverage**
Crowns (excluding implant crowns)
Root Canals
Dentures / Bridges
Periodontics

** basic/6 mo. waiting period
**major/12 mo. waiting period

ENROLL NOW

**Waiting periods may be waived if you were covered under an employer-sponsored group policy within 60 days of the start of your coverage under this policy, or an individual policy within 30 days of the start of your coverage under this policy. Momentum Platinum and Gold Plans do not cover oral surgery, implants, implant related services, orthodontics or cosmetic services.
MONTHLY PREMIUM

^$217.50

per month

Dental Health Associates of Madison

member annual maximum benefit
$1,200

$50 Deductible / $150 Family

100% COVERAGE/YR

Waived for Preventive & Diagnostic

2 cleanings (every 6 mo.)

2 exams (every 6 mo.)

1 set of bitewing x-rays (once per year)

Fluoride treatment (through age 18)

Panoramic x-ray (once per 5 yr. period)

Sealants (through age 18)

ALSO COVERED

75% Basic Restorative coverage**

Fillings

Simple Extractions

50% Major Restorative coverage**

Crowns (excluding implant crowns)

Root Canals

Dentures / Bridges

Periodontics

** basic/6 mo. waiting period
**major/12 mo. waiting period

ENROLL NOW

**Waiting periods may be waived if you were covered under an employer-sponsored group policy within 60 days of the start of your coverage under this policy, or an individual policy within 30 days of the start of your coverage under this policy. Momentum Platinum and Gold Plans do not cover oral surgery, implants, implant related services, orthodontics or cosmetic services.
MONTHLY PREMIUM

^$42.00

per month

FIND A DENTIST

member annual maximum benefit
$1,200

$50 Deductible / $150 Family

80% COVERAGE/YR

Applies to Preventive & Diagnostic

2 cleanings (every 6 mo.)

2 exams (every 6 mo.)

1 set of bitewing x-rays (once per year)

Fluoride treatment (through age 18)

Panoramic x-ray (once per 5 yr. period)

Sealants (through age 18)

ALSO COVERED

60% Basic Restorative coverage**
Fillings
Simple Extractions
50% Major Restorative coverage**
Crowns
Root Canals
Dentures / Bridges
Periodontics

** basic/6 mo. waiting period
**major/12 mo. waiting period

ENROLL NOW

**Waiting periods may be waived if you were covered under an employer-sponsored group policy within 60 days of the start of your coverage under this policy, or an individual policy within 30 days of the start of your coverage under this policy. Momentum Platinum and Gold Plans do not cover oral surgery, implants, implant related services, orthodontics or cosmetic services.
MONTHLY PREMIUM

^$49.50

per month

FIND A DENTIST

member annual maximum benefit
$1,200

$50 Deductible / $150 Family

100% COVERAGE/YR

Waived for Preventive & Diagnostic

2 cleanings (every 6 mo.)

2 exams (every 6 mo.)

1 set of bitewing x-rays (once per year)

Fluoride treatment (through age 18)

Panoramic x-ray (once per 5 yr. period)

Sealants (through age 18)

ALSO COVERED

75% Basic Restorative coverage**
Fillings
Simple Extractions
50% Major Restorative coverage**
Crowns
Root Canals
Dentures / Bridges
Periodontics

** basic/6 mo. waiting period
**major/12 mo. waiting period

ENROLL NOW

**Waiting periods may be waived if you were covered under an employer-sponsored group policy within 60 days of the start of your coverage under this policy, or an individual policy within 30 days of the start of your coverage under this policy. Momentum Platinum and Gold Plans do not cover oral surgery, implants, implant related services, orthodontics or cosmetic services.
MONTHLY PREMIUM

$84.00

per month

FIND A DENTIST

member annual maximum benefit
$1,200

$50 Deductible / $150 Family

80% COVERAGE/YR

Applies to Preventive & Diagnostic

2 cleanings (every 6 mo.)

2 exams (every 6 mo.)

1 set of bitewing x-rays (once per year)

Fluoride treatment (through age 18)

Panoramic x-ray (once per 5 yr. period)

Sealants (through age 18)

ALSO COVERED

60% Basic Restorative coverage**
Fillings
Simple Extractions
50% Major Restorative coverage**
Crowns
Root Canals
Dentures / Bridges
Periodontics

** basic/6 mo. waiting period
**major/12 mo. waiting period

ENROLL NOW

**Waiting periods may be waived if you were covered under an employer-sponsored group policy within 60 days of the start of your coverage under this policy, or an individual policy within 30 days of the start of your coverage under this policy. Momentum Platinum and Gold Plans do not cover oral surgery, implants, implant related services, orthodontics or cosmetic services.
MONTHLY PREMIUM

$99.00

per month

FIND A DENTIST

member annual maximum benefit
$1,200

$50 Deductible / $150 Family

100% COVERAGE/YR

Waived for Preventive & Diagnostic

2 cleanings (every 6 mo.)

2 exams (every 6 mo.)

1 set of bitewing x-rays (once per year)

Fluoride treatment (through age 18)

Panoramic x-ray (once per 5 yr. period)

Sealants (through age 18)

ALSO COVERED

75% Basic Restorative coverage**
Fillings
Simple Extractions
50% Major Restorative coverage**
Crowns
Root Canals
Dentures / Bridges
Periodontics

** basic/6 mo. waiting period
**major/12 mo. waiting period

ENROLL NOW

**Waiting periods may be waived if you were covered under an employer-sponsored group policy within 60 days of the start of your coverage under this policy, or an individual policy within 30 days of the start of your coverage under this policy. Momentum Platinum and Gold Plans do not cover oral surgery, implants, implant related services, orthodontics or cosmetic services.
MONTHLY PREMIUM

$159.50

per month

FIND A DENTIST

member annual maximum benefit
$1,200

$50 Deductible / $150 Family

80% COVERAGE/YR

Applies to Preventive & Diagnostic

2 cleanings (every 6 mo.)

2 exams (every 6 mo.)

1 set of bitewing x-rays (once per year)

Fluoride treatment (through age 18)

Panoramic x-ray (once per 5 yr. period)

Sealants (through age 18)

ALSO COVERED

60% Basic Restorative coverage**
Fillings
Simple Extractions
50% Major Restorative coverage**
Crowns
Root Canals
Dentures / Bridges
Periodontics

** basic/6 mo. waiting period
**major/12 mo. waiting period

ENROLL NOW

**Waiting periods may be waived if you were covered under an employer-sponsored group policy within 60 days of the start of your coverage under this policy, or an individual policy within 30 days of the start of your coverage under this policy. Momentum Platinum and Gold Plans do not cover oral surgery, implants, implant related services, orthodontics or cosmetic services.
MONTHLY PREMIUM

$187.25

per month

FIND A DENTIST

member annual maximum benefit
$1,200

$50 Deductible / $150 Family

100% COVERAGE/YR

Waived for Preventive & Diagnostic

2 cleanings (every 6 mo.)

2 exams (every 6 mo.)

1 set of bitewing x-rays (once per year)

Fluoride treatment (through age 18)

Panoramic x-ray (once per 5 yr. period)

Sealants (through age 18)

ALSO COVERED

75% Basic Restorative coverage**
Fillings
Simple Extractions
50% Major Restorative coverage**
Crowns
Root Canals
Dentures / Bridges
Periodontics

** basic/6 mo. waiting period
**major/12 mo. waiting period

ENROLL NOW

**Waiting periods may be waived if you were covered under an employer-sponsored group policy within 60 days of the start of your coverage under this policy, or an individual policy within 30 days of the start of your coverage under this policy. Momentum Platinum and Gold Plans do not cover oral surgery, implants, implant related services, orthodontics or cosmetic services.
MONTHLY PREMIUM

$159.50

per month

FIND A DENTIST

member annual maximum benefit
$1,200

$50 Deductible / $150 Family

80% COVERAGE/YR

Applies to Preventive & Diagnostic

2 cleanings (every 6 mo.)

2 exams (every 6 mo.)

1 set of bitewing x-rays (once per year)

Fluoride treatment (through age 18)

Panoramic x-ray (once per 5 yr. period)

Sealants (through age 18)

ALSO COVERED

60% Basic Restorative coverage**
Fillings
Simple Extractions
50% Major Restorative coverage**
Crowns
Root Canals
Dentures / Bridges
Periodontics

** basic/6 mo. waiting period
**major/12 mo. waiting period

ENROLL NOW

**Waiting periods may be waived if you were covered under an employer-sponsored group policy within 60 days of the start of your coverage under this policy, or an individual policy within 30 days of the start of your coverage under this policy. Momentum Platinum and Gold Plans do not cover oral surgery, implants, implant related services, orthodontics or cosmetic services.
MONTHLY PREMIUM

$187.25

per month

FIND A DENTIST

member annual maximum benefit
$1,200

$50 Deductible / $150 Family

100% COVERAGE/YR

Waived for Preventive & Diagnostic

2 cleanings (every 6 mo.)

2 exams (every 6 mo.)

1 set of bitewing x-rays (once per year)

Fluoride treatment (through age 18)

Panoramic x-ray (once per 5 yr. period)

Sealants (through age 18)

ALSO COVERED

75% Basic Restorative coverage**
Fillings
Simple Extractions
50% Major Restorative coverage**
Crowns
Root Canals
Dentures / Bridges
Periodontics

** basic/6 mo. waiting period
**major/12 mo. waiting period

ENROLL NOW

**Waiting periods may be waived if you were covered under an employer-sponsored group policy within 60 days of the start of your coverage under this policy, or an individual policy within 30 days of the start of your coverage under this policy. Momentum Platinum and Gold Plans do not cover oral surgery, implants, implant related services, orthodontics or cosmetic services.
MONTHLY PREMIUM

$184.50

per month

FIND A DENTIST

member annual maximum benefit
$1,200

$50 Deductible / $150 Family

80% COVERAGE/YR

Applies to Preventive & Diagnostic

2 cleanings (every 6 mo.)

2 exams (every 6 mo.)

1 set of bitewing x-rays (once per year)

Fluoride treatment (through age 18)

Panoramic x-ray (once per 5 yr. period)

Sealants (through age 18)

ALSO COVERED

60% Basic Restorative coverage**
Fillings
Simple Extractions
50% Major Restorative coverage**
Crowns
Root Canals
Dentures / Bridges
Periodontics

** basic/6 mo. waiting period
**major/12 mo. waiting period

ENROLL NOW

**Waiting periods may be waived if you were covered under an employer-sponsored group policy within 60 days of the start of your coverage under this policy, or an individual policy within 30 days of the start of your coverage under this policy. Momentum Platinum and Gold Plans do not cover oral surgery, implants, implant related services, orthodontics or cosmetic services.
MONTHLY PREMIUM

$212.25

per month

FIND A DENTIST

member annual maximum benefit
$1,200

$50 Deductible / $150 Family

100% COVERAGE/YR

Waived for Preventive & Diagnostic

2 cleanings (every 6 mo.)

2 exams (every 6 mo.)

1 set of bitewing x-rays (once per year)

Fluoride treatment (through age 18)

Panoramic x-ray (once per 5 yr. period)

Sealants (through age 18)

ALSO COVERED

75% Basic Restorative coverage**
Fillings
Simple Extractions
50% Major Restorative coverage**
Crowns
Root Canals
Dentures / Bridges
Periodontics

** basic/6 mo. waiting period
**major/12 mo. waiting period

ENROLL NOW

**Waiting periods may be waived if you were covered under an employer-sponsored group policy within 60 days of the start of your coverage under this policy, or an individual policy within 30 days of the start of your coverage under this policy. Momentum Platinum and Gold Plans do not cover oral surgery, implants, implant related services, orthodontics or cosmetic services.
MONTHLY PREMIUM

^$209.50

per month

FIND A DENTIST

member annual maximum benefit
$1,200

$50 Deductible / $150 Family

80% COVERAGE/YR

Applies to Preventive & Diagnostic

2 cleanings (every 6 mo.)

2 exams (every 6 mo.)

1 set of bitewing x-rays (once per year)

Fluoride treatment (through age 18)

Panoramic x-ray (once per 5 yr. period)

Sealants (through age 18)

ALSO COVERED

60% Basic Restorative coverage**
Fillings
Simple Extractions
50% Major Restorative coverage**
Crowns (excluding implant crowns)
Root Canals
Dentures / Bridges
Periodontics

** basic/6 mo. waiting period
**major/12 mo. waiting period

ENROLL NOW

**Waiting periods may be waived if you were covered under an employer-sponsored group policy within 60 days of the start of your coverage under this policy, or an individual policy within 30 days of the start of your coverage under this policy. Momentum Platinum and Gold Plans do not cover oral surgery, implants, implant related services, orthodontics or cosmetic services.
MONTHLY PREMIUM

^$237.25

per month

FIND A DENTIST

member annual maximum benefit
$1,200

$50 Deductible / $150 Family

100% COVERAGE/YR

Waived for Preventive & Diagnostic

2 cleanings (every 6 mo.)

2 exams (every 6 mo.)

1 set of bitewing x-rays (once per year)

Fluoride treatment (through age 18)

Panoramic x-ray (once per 5 yr. period)

Sealants (through age 18)

ALSO COVERED

75% Basic Restorative coverage**

Fillings

Simple Extractions

50% Major Restorative coverage**

Crowns (excluding implant crowns)

Root Canals

Dentures / Bridges

Periodontics

** basic/6 mo. waiting period
**major/12 mo. waiting period

ENROLL NOW

**Waiting periods may be waived if you were covered under an employer-sponsored group policy within 60 days of the start of your coverage under this policy, or an individual policy within 30 days of the start of your coverage under this policy. Momentum Platinum and Gold Plans do not cover oral surgery, implants, implant related services, orthodontics or cosmetic services.

Procedures Covered

Dental procedures range from simple preventive cleanings and root canals. Different insurance plans cover different procedures, and different dentists perform different procedures. Individual dental insurance from Momentum Plans covers common dental procedures; including (but not limited to):

CLEANINGS

EXAMS

FLUORIDE TREATMENTS

through age 18

ROOT CANALS*

CROWNS*

BRIDGES*

FILLINGS*

TOOTH EXTRACTIONS*

*Momentum’s Gold and Platinum Plans cover a portion of these services. See plan details for more information.

Individual Commercial Plans

For All of Wisconsin

Even if you don’t live in the Madison area, you can still receive excellent dental coverage! Momentum Insurance Plans, Inc. offers commercial individual plans. Our commercial individual plans have been carefully designed by Momentum to meet the dental care needs and budget restraints of families in Wisconsin.

Dental Coverage Options for Individuals & Families

Affordable Dental Insurance Options

Wisconsin residents find dental coverage for themselves and their families at rates they can afford. Choose the plan you need and schedule your first appointment in minutes.

Have a Question?

Our highly trained team of dental insurance specialists are available to answer any questions you may have while deciding which plan is right for you. Simply contact us online or give us a call at 608-729-6500 to learn more!

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Dental Plans

Flexible Plan Pricing & Coverage

Find Your Perfect Coverage

MONTHLY PREMIUM

$25

per month

No Annual Maximum$0

$0 DEDUCTIBLE

100% COVERAGE/YR

Courtesy Discount

10% Other Services**

MONTHLY PREMIUM

$37.75

per month

member annual maximum benefit$1,200

$50 Deductible / $150 Family

80% COVERAGE/YR

Applies to Preventive & Diagnostic

ALSO COVERED

60% Basic Restorative coverage**

50% Major Restorative coverage**

MONTHLY PREMIUM

$44.25

per month

member annual maximum benefit $1,200

$50 Deductible / $150 Family

100% COVERAGE/YR

Waived for Preventive & Diagnostic

ALSO COVERED

75% Basic Restorative coverage**

50% Major Restorative coverage**

MONTHLY PREMIUM

$50

per month

No Annual Maximum$0

$0 DEDUCTIBLE

100% COVERAGE/YR

Courtesy Discount

10% Other Services**

MONTHLY PREMIUM

$75.50

per month

member annual maximum benefit$1,200

$50 Deductible / $150 Family

80% COVERAGE/YR

Applies to Preventive & Diagnostic

ALSO COVERED

60% Basic Restorative coverage**

50% Major Restorative coverage**

MONTHLY PREMIUM

$88.50

per month

member annual maximum benefit $1,200

$50 Deductible / $150 Family

100% COVERAGE/YR

Waived for Preventive & Diagnostic

ALSO COVERED

75% Basic Restorative coverage**

50% Major Restorative coverage**

MONTHLY PREMIUM

$75

per month

No Annual Maximum$0

$0 DEDUCTIBLE

100% COVERAGE/YR

Courtesy Discount

10% Other Services**

MONTHLY PREMIUM

$143.50

per month

member annual maximum benefit$1,200

$50 Deductible / $150 Family

80% COVERAGE/YR

Applies to Preventive & Diagnostic

ALSO COVERED

60% Basic Restorative coverage**

50% Major Restorative coverage**

^$25

No Annual Maximum
$0

^$37.75

member annual maximum benefit
$1,200

^$44.25

member annual maximum benefit
$1,200

^$50

No Annual Maximum
$0

^$75.50

member annual maximum benefit
$1,200

^$88.50

member annual maximum benefit
$1,200

^$75

No Annual Maximum
$0

^$143.50

member annual maximum benefit
$1,200

^$167.50

member annual maximum benefit
$1,200

^$100

No Annual Maximum
$0

^$143.50

member annual maximum benefit
$1,200

^$167.50

member annual maximum benefit
$1,200

^$125

No Annual Maximum
$0

^$168.50

member annual maximum benefit
$1,200

^$192.50

member annual maximum benefit
$1,200

^$150

No Annual Maximum
$0