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Summary
of Benefits
Vantage Care
Co-Payment Plan (b)
In-Network Only
Vantage Choice
TDA dentalCOMPANION PPO / INDEMNITY (a)
In-Network / Out-of-Network
Preventive
Office visit, cleaning, oral exam and x-rays
100%
after $10 co-pay(*)

Examples: D120 (Periodic Oral Exam) plan allows $20 (c,d)
D1110 (Prophlaxis-Adult) plan allows $45 (c,d)

Basic
Simple extractions and fillings
75-80%
average savings(*)
Examples: D2140 (Amalgam-one Surface Prim/Prem) plan allows $45 (c,d) D3330 (Molar Root Canal) plan allows $248 (c,d)
Major
Crowns, bridges, dentures, inlays, periodontics, endodontics and oral surgery
50-60%
average savings(*)

Examples: D2752 (Crown-Porcelain Fused to Noble Metal) plan allows $247 (c,d)  D5120 (Complete Denture-Mandibular) plan allows $289 (c,d)

Orthodontics
15-25% average discount
25% discount at participating TDA providers / No Out of Network Benefits
Waiting Periods
None 12 month waiting period on major services
Deductible
None $50 per person per calendar year for basic and major services
Annual Maximum
None $1,000 per subscriber
Additional Information 20% discount on specialist services:Periodontist, Endondontist, Prosthodontist,Perdiatrics and Oral Surgeon.DHMO Network (executive plan) dentalCOMPANION PPO / INDEMNITY PLAN
This percentage is based on an average savings please see plan certificate for reimbursement amount and about the plan benefits. TDA PPO Network
Payment
Method
Monthly
Monthly Rate
Under 65
Monthly Rate
Over Age 65+

All Plans allow Monthly payments by Visa, MasterCard, Discover or automatic bank account withdrawals.

Automatic payment comes out on the 18th of each month.

There is a one time enrollment fee of $10.00 for all new applications. Please include it with your first month premium payment.

Plans start on the 1st of each month.

 

Single $17.25
Two Party $34.50
Family $55.75
(a) / (b) Vantage Care Plan insured and underwritten by Total Dental Administrators. For complete fee schedule please refer to the plan certificate. (b) All payments made by the plan are based on the network fee schedule from TDA PPO Network. For complete details of the coverage please refer to the plan certificate.. Plans may vary by state.

(*) See co-pay schedule.

Single $34.89 $41.87
Two Party $67.14 $79.70
Family 110.05 $123.38
The TDA PPO / Vantage Choice is a defined reimbursement dental plan. The plan has a set reimbursement amount for each covered dental procedure (see examples above). To calculate the consumer’s cost, take the contracted rate that the dental provider will charge minus the insurance reimbursement and the difference is the consumer’s responsibility. Therefore, the consumer can know exactly what the insurance company will pay, what the provider will charge and what his or her own responsibly is.

Consumers will get the best deal when using a contracted (in-network) provider. If consumers choose to use a non-network provider they will still receive a reimbursement. However, they will not receive the lower negotiated rates available with in-network providers. Therefore, it will be more expensive to use an out-of-network provider.

For more information see plan certificate.

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Vantage Choice
Vantage Care
Vantage Access