Gersh Plan Example DHMO vs DPPO
For illustrative purposes only. Please refer to your plan documents for all plan details.
DHMO
DPPO
In-Network
In-Network
Out-of-Network
Annual Deductible Individual | Family
None
$50 | $150
Calendar Year Plan Max
Unlimited
$2,500 per person
100% Deductible Waived
Preventive Care Benefits
100% Deductible Waived
$5 Copay
Refer to Copay Schedule
100% Deductible Waived
You pay 20% after deductible
Basic Services
Refer to Copay Schedule
You pay 40% after deductible
You pay 50% after deductible
Major Services
Orthodontia (Child | Adult)
$1,104 to $5,425
50% up to $2,000 Lifetime Maximum
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