Graham County Dental Benefits

Information on Graham County dental plans, provider links and helpful forms.

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How many times a year can I have my teeth cleaned?

The AZLGEBT dental plan allows for two (2) cleaning per calendar year (Jan 01 – Dec 31).

Does the AZLGEBT dental plan cover orthodontics (braces)?

Orthodontia benefits are provided up to the age of nineteen (19).  Benefits are subject to the deductible and 50% coinsurance up to a maximum payable per lifetime of $1,750.  Orthodontic benefit limitations include no coverage for treatment which commenced before the date the Plan member became eligible for benefits and a member who is added more than thirty-one (31) days after he/she was eligible will have a twenty-four (24) month waiting period before coverage will be provided. The waiting period can be reduced by providing a “Certificate of Creditable Coverage” from the Plan Member’s prior dental carrier.

Is there a limit on how much the plan will pay for dental services?

Yes.  The plan will pay up to $1,750 per person per plan year for dental services and up to $1,750 per lifetime for orthodontic services.

What is coordination of benefits?

When a person is covered by more than one benefit plan (for example, a child who is covered by both parent’s programs), which is known as dual coverage, the two sets of benefits are coordinated so that no more than 100 percent of the total covered expense is paid.

What qualifies as a dental emergency?

Dental services that are immediately required to relieve pain, swelling or bleeding, or required to avoid jeopardizing the patient’s health qualifies as a dental emergency.

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Dental Benefits

BENEFIT DESCRIPTION                                 AMOUNT PAYABLE BY PLAN
In-Network Out-of-Network
Annual Deductible (Jan-Dec) $50 per Person/ $150 per Family $100 per Person/$300 per Family
Annual Benefit Maximum (Jan – Dec) $2,000 per Person $1,500 per Person
   Preventative Care 100% – no deductible 80% – no deductible
   Restorative Care 80%* 50%*
   Routine Extractions 80%* 50%*
   Endodontics 80%* 50%*
   Periodontics 80%* 50%*
   Oral Surgery 80%* 50%*
   Prosthodontics/Prosthetics 50%* 40%*
   Orthodontics (For children banded by age 17) 50%* 50%*
   Lifetime Orthodontic Maximum $1,000 per Person $1,000 per Person

* Subject to Deductible
For more detailed coverage information, please contact your benefits department.
NOTE: If you use a non-preferred provider, the dentist can balance bill you for services outside the contracted amount payable.