| Plan Details | ||
|---|---|---|
| Plan Name | DHMO Plan | |
| Effective Dates | Jan 01, 2024 to Jan 01, 2026 | |
| Benefits | In-Network | |
| Annual Deductible/Individual | $0 | |
| Annual Deductible/Family | $0 | |
| Annual Plan Maximum | N/A | |
| Lifetime Orthodontia Plan Maximum | N/A | |
| Diagnostic and Preventive Services | 0% | |
| Basic Services | 10% | |
| Major Services | 40% | |
| Orthodontia Services | 50% | |
| Ortho Dependent Children | N/A | |
| Ortho Adults (and Covered Full-Time Students, if Eligible) | Covered | |