Summary of Benefits

TDA Vantage Care


Co-Payment Plan (a)

In-Network Only

TDA Vantage Choice


Dental COMPANION PPO / INDEMNITY (b)

In-Network / Out-of-Network
Preventive
Office visit, cleaning, oral exam and x-rays
100%
after $20 co-pay (*)
80 - 100%
average savings (*) (d) (c)
Basic
Simple extractions and fillings
60 - 80%
average savings (*) (d)
70 - 80%
average savings (*) (d) (c)
Major
Crowns, bridges, dentures, inlays, periodontics, endodontics and oral surgery
40 - 60%
average savings (*) (d)
40 - 60%
average savings (*) (d) (c)
Orthodontics15-25%
average discount
25% discount at participating TDA Providers / No Out of Network Benefits
Waiting PeriodsNone12 month waiting period on major services
DeductibleNone$50 per person per calendar year for
basic and major services
Annual MaximumNone$1,000 per person
Additional Information20% discount on specialist services:  Periodontist, Endondontist, Prosthodontist, Pediatrics and Oral Surgeon.
DHMO Network (Executive Plan)
dentalCOMPANION PPO / INDEMNITY PLAN
(c) 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

TDA Vantage Care


Monthly

TDA Vantage Choice





Monthly Rate

Under Age 65
Monthly Rate

Over Age 65+
All plans allow monthly payments by Visa, MasterCard, Discover or automatic bank account withdrawals.

There is a one time enrollment fee of $10.00 for all new applications.

All applications received before the 18th of the month start on the 1st of the following month.

Automatic payment comes out on the 20th of each month.

For plan information visit: www.vpdental.com




















Single $18.85
Two Party $37.65
Family $60.80

For more information on the TDA DHMO Vantage CARE plan benefits,

please see plan certificate.


Minimum enrollment age is 18,unless accompanied by an adult.


























Single $39.50 $47.40
Two Party $75.95 $90.20
Family $124.50 $139.60

TDA PPO / Vantage Choice is a defined reimbursement plan, that puts you as the consumer in the driver’s seat. How the plan works, we provide you with a set dollar amount per procedure. This amount minus our contracted rate that we have set with the in-network dentist will provide you with your reimbursements.


If you go out of network please remember, the plan does give you some reimbursement. However you do not receive the discounted contracted rate that we have set up with our in-network dentist, and also do not forget the dentist can balance bill for the difference,

please see plan certificate.



Minimum enrollment age is 18, unless accompanied by an adult.

TDA / Vantage Choice Plan insured by Companion Life Insurance Company. (b) Vantage Care Plan insured and underwritten by Total Dental Administrators. For complete fee schedule please refer to the plan certificate (c) This percentage is based on and average savings please see plan certificate for reimbursement amount see the plan certificate for more information. (*) see copay schedule. PPO reimbursement , see the Mid-Plan co-pay on the plan certificate. (d) All payments made by the plan are based on the network fee schedule TDA PPO network / DHMO network. For complete details of the coverage please refer to the plan certificate. Plans may vary by state.

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TDA Vantage Care
CARE Plan
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TDA Vantage Choice
Choice Plan
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