DENTAL AND VISION INSURANCE
Homes by West Bay offers dental and vision through Principal. The dental PPO Plan allows you to use in-network or out-of-network benefits. If out-of-network dentists are used, you will be responsible to pay the difference between Principal’s allowed amount and what the dentist may charge. The vision plan provides coverage both in and out of network. The charts below provides a brief overview of the plans.
Dental PPO Plan
In-Network
Out-of Network
Deductible Individual
$50
$50
$150
$150
Family
Annual Maximum
$1,000
Individual Diagnostic & Preventative Exams Cleanings Fluoride X-Rays Sealants Regular Restorative Services Extractions - Single Tooth Endodontics (Root Canal) Periodontics ( Gum Disease) Major Services Amalgam Fillings
100%
100%
Deductible Applies
80%
80%
Deductible Applies
Crowns Bridges Dentures
50%
50%
Vision VSP Network
In-Network
Out-of-Network
Lenses Single Bifocal Trifocal
$50 allowance $75 allowance $100 allowance $150 allowance $100 allowance $50 allowance
$50 allowance $75 allowance $100 allowance $150 allowance $100 allowance $50 allowance
Contact Lenses
Frames Exams
Frequency Exam
Once every 12 months Once every 12 months Once every 24 months
Lenses or contact lenses
Frame
20% retail discount on a second pair of eyeglasses on the day of exam or 20% from any VSP doctor within 12 months of last exam. Special discounts available through contracted LASIK and PRK surgery facilities
Additional Pairs
Laser Vision Correction
7
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