Dental

Farm Bureau Health Plans

Dental

About the Plan
With a Farm Bureau Health Plans dental plan, individuals and families get affordable financial protection for not only preventive services and routine exams, but a more extensive range of services over time.  

Highlights: Farm Bureau Health Plans uses UnitedHealthcare Managed Dental Network. Please keep in mind that in-network payments are based on negotiated fees. If an out-of-network provider is used, the member’s liability will increase significantly.
 

Download Schedule of Benefits

  Copayment Benefits

Benefits available after 90 days

$15 copayment per examination-100% of maximum allowable charge

  • Two routine periodic examinations in any 12-month period.
  • Bitewing X-rays once in every 12-month period.
  • Full mouth X-rays once in any 36-month period.
  • Topical fluoride application for members under age 19, once in any 12-month interval.
  • Prophylaxis and periodontal maintenance, not to exceed 2 per year.
  • Any combination of exams -- initial, periodic emergency or periodontal -- limited to 3 times in a 12-month period.

Benefits available after 12 months

$15 copayment for each of the following services – 100% of the maximum allowable charge

  • Sealants, only for occlusal (biting) surface of first and second permanent molar teeth on members under 16 years of age. Only 1 sealant benefit will be allowed on each tooth per lifetime of coverage. The copayment applies per tooth for this service.

$25 copayment for each of the following services – 100% of the maximum allowable charge

  • Emergency treatment for relief of pain.
  • Restorative services: filling material such as amalgam, synthetic porcelain and composite restorations--limited to 1 restoration per surface per tooth per year. The copayment applies per tooth for this service.
  • Oral surgery: provides for routine extractions (non-impacted), including pre- and post-operative care. The copayment applies per tooth for this service.
  • Repair of full and partial dentures after 12 month initial placement. The copayment applies per procedure – upper and lower dentures are considered separate procedures.
  • Stainless steel crowns. The copayment applies per tooth for this service.
  • Bridge repair after 6 month initial placement. The copayment applies per procedure.
  • Crown repair after 6 month initial placement. The copayment applies per procedure.

$75 copayment for each of the following services - 100% of the maximum allowable charge

  • Endodontics: root canal treatment. The copayment applies per tooth for this service.
  • Periodontics: treatment for diseases of the gums and bones supporting teeth. The copayment applies per procedure.
  • Surgical extractions (impactions). The copayment applies per tooth.
  • Space maintainers for members up to age 14. The copayment applies per procedure.
  • Relining and rebasing of full and partial dentures limited to 1 upper and 1 lower every 3 years. Separate copayments for upper and lower.

Benefits available after 24 months

$75 copayment for each of the following services - 50% of the maximum allowable charge

  • Full and partial upper and lower dentures. Separate copayments for upper and lower.
  • Benefits will be provided for any necessary adjustments for a 6-month period.
  • Initial placement of fixed and removable bridges by standard procedure. The copayment applies per tooth.
  • Cast crowns for treatment of severe carious lesions or severe fracture when the tooth cannot be restored with amalgam, synthetic porcelain or composite restorations. The copayment applies per tooth.
  • Cast inlays/onlays (copayment per tooth).
  • Laminate veneers (copayment per tooth).

Annual maximum benefit

$1,500 per member

Ready to Apply Now?

Farm Bureau Health Plans is proud to offer quality coverage at an affordable cost. Download an application to get started.

Medicare Supplements Insured by TRH Health Insurance Company, Columbia, TN.
TRHH-POST-POLA-FL14-174; TRHH-POST-POLB-FL14-175; TRHH-POST-POLC-FL14-176; TRHH-POST-POLD-FL14-177; 
TRHH-POST-POLF-FL14-178; TRHH-POST-POLG-FL14-179; TRHH-POST-POLM-FL14-180; TRHH-POST-POLAN-FL14-181
Not connected with or endorsed by the U.S. or state government. This is a solicitation of insurance. A representative of TRH Health Insurance Company may contact you. Benefits not provided for expenses incurred while coverage under the policy is not in force, expenses payable by Medicare, non- Medicare eligible expenses or any Medicare deductible or copayment/coinsurance or other expenses not covered under the policy.