Dental, Vision & Hearing

This limited benefit insurance policy from ManhattanLife offers comprehensive coverage for essential dental, vision, and hearing care—often not covered by basic Medicare. Designed for individuals ages 18–85, the plan provides annual benefit options ranging from $1,000 to $5,000, with guaranteed issue and lifetime renewability. Covered services include preventive dental exams, major dental procedures, eye exams, glasses or contacts, and hearing aids or repairs. Members may use any provider, with optional access to the Careington PPO network for potential savings. It’s flexible, family-friendly coverage that helps protect your health and budget.

A plan with choices for you and your family

Dental, Vision and Hearing Insurance

The Importance of Dental | Vision | Hearing

• Quality of Life • Unforeseen situations that are painful, inconvenient and expensive • Basic Medicare does not cover dental, vision or hearing expenses

Protect Your Smile and Smile Brighter!

PRODUCTS HIGHLIGHTS

• Choose your dentist - In network or out of network • Family Rates (includes a maximum of 3 children) • Individual 18 - 85 • $1,000 - $5,000 policy year benefit option available • Guaranteed Issue • Guaranteed renewable for life* * Subject to our right to change premiums. NEW! Careington Network Clients can now access the Careington Maximum Care PPO Dental Network. Use of network completely optional. • Policyholders can now use, if they choose, a dental provider from the Careington Dental network. • Policyholders can also use the dentist of their choice, even if not part of the dental network. • Network discounts may help extend the policy year maximum with reduced charges. • Careington can be contacted at (800) 290-0523.

Protect Your Sight and See Clearer!

Protect Your Hearing and Hear Better!

This is a Limited Benefit Insurance Policy for Dental, Vision and Hearing Expenses Underwritten by ManhattanLife Insurance and Annuity Company

Not available in all states

DVH7016-BR 0823

PLAN BENEFITS 1

INDIVIDUAL MONTHLY PREMIUM Age $1,000 $1,500 $3,000 $5,000 18 - 39 $30.24 $39.98 $48.15 $60.64 40 - 54 $32.74 $42.40 $52.23 $65.56 55 - 64 $35.07 $45.98 $59.56 $73.72 65 - 74 $37.57 $49.65 $64.39 $78.97 75 - 85 $43.15 $57.06 $74.05 $88.63 FAMILY MONTHLY PREMIUM * Age $1,000 $1,500 $3,000 $5,000 18 - 39 $96.79 $127.70 $154.19 $199.09 40 - 54 $101.63 $132.61 $159.85 $208.92 55 - 64 $106.54 $139.86 $172.60 $225.24 65 - 74 $111.37 $147.11 $190.59 $235.74 75 - 85 $128.03 $169.18 $219.50 $255.06 CHILD MONTHLY PREMIUM * Age $1,000 $1,500 $3,000 $5,000 3 - 17 $22.74 $29.99 $36.15 $48.65 * Family rates include up to three children. Additional children are charged the age 3 - 17 rate per person. * Individual and (1) child will be charged an individual + child rate. Premiums are subject to change. Premium rates based on $1,000, $1,500, $3,000 or $5,000 Policy Year Maximum. Use the age of the oldest applicant. Benefit exclusions and limitations apply.

Eligibility

Anyone age 18 - 85 $1,000, $1,500, $3,000 o $5,000 (choose one) $100 per person

Policy Year Maximum Benefit

Policy Year Deductible

Dental Coverage Preventive Services Semi-Annual exams, cleaning and x-rays

Year 1 - 60% Year 2 - 70% Year 3 and thereafter - 80%

Waiting Period

None

Year 1 - 60% Year 2 - 70% Year 3 and thereafter - 80%

Basic Services Including x-ray, fillings and extractions (other than “full mouth”)

Waiting Period

None

Major Services Including bridges, crowns, full dentures or partials, full mouth extractions, and root canals

Year 1 - 0% Year 2 - 70% Year 3 and thereafter - 80%

Waiting Period

12 months

Vision Coverage Basic eye exam, eye refraction, including the cost of eye glasses or contact lenses

Year 1 - 60% Year 2 - 70% Year 3 and thereafter - 80% 6 months on eyeglasses and contact lenses Year 1 - 60% Year 2 - 70% Year 3 and thereafter - 80% 12 months new hearing aids and existing hearing aid repairs

Waiting Period

Hearing Coverage

Exam, hearing aid and necessary repairs or supplies

Waiting Period

Policy Form Numbers: AK7016, AK7016-ID, AK7016-LA, AK7016-MT, AK7016-OK, AK7016-TX (including state variations)

1 Refer to your policy for a complete description of limitations and exclusions.

Underwritten by: ManhattanLife Insurance and Annuity Company 10777 Northwest Freeway, Houston, TX 77092 Toll Free Telephone: 800-669-9030

This is not a complete disclosure of plan qualifications and limitations. Please access our website to obtain a completed list for the Dental, Vision and Hearing product at disclosure.manhattanlife.com . Please review this information before applying for coverage. The amounts of benefits provided depend on the plan selected. Premiums will vary according to the selection made.

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www.manhattanlife.com

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