Retiree Dental Plan
The Retiree Dental Plan is NOT INSURANCE, therefore all applicants are guaranteed acceptance. This plan is exclusively designed for Union members only.
This plan is great for my husband and me.
Being on a fixed income, it is important that we know the costs of our dental services up front. With this plan we can get the services we need, when we need them. We can do regular cleanings a price we can afford, with no surprises. That is what we like the most. The plan is straightforward, easy to use, and easy to understand.
Finally, a plan with REAL discounts!
This plan works for me because I can use it as often as I like or just for cleanings and exams. Then if I need unplanned dental work, this plan helps minimize my dental expenses. I may be retired now, but I live a healthy life and know maintaining good oral health is an important part of that.
Summary of Discounts
| ADA Code | Diagnostic & Preventative | You Pay |
| D0150 | Comprehensive oral evaluation | $30.50 |
| D0120 | Periodic oral evaluation | $30.50 |
| D0210 | Intraoral - complete series of radiographic images | $58.00 |
| D0220 | Intraoral - periapical first radiographic image | $16.00 |
| D0230 | Intraoral - periapical each additional radiographic image | $15.00 |
| D0330 | Panoramic radiographic image | $50.00 |
| D1110 | Prophylaxis (Cleaning) Adult | $46.00 |
| D1120 | Prophylaxis (Cleaning) Child | $46.00 |
| D1351 | Sealant - per tooth | $19.00 |
| D1208 | Topical application of fluoride | $18.00 |
| ADA Code | Restorative | You Pay |
| Resin-based composite-anterior | ||
| D2330 | One surface | $69.50 |
| D2331 | Two surfaces | $105.00 |
| D2332 | Three surfaces | $116.00 |
| D2335 | Four or more surfaces | $116.00 |
| Resin-based composite-posterior | ||
| D2391 | One surface | $93.00 |
| D2392 | Two surfaces | $116.00 |
| D2393 | Three surfaces | $139.00 |
| D2393 | Four or more surfaces | $139.00 |
| ADA Code | Crowns | You Pay |
| D2740 | Crown – porcelain/ceramic substrate | $678.00 |
| D2750 | Crown - porcelain fused to high noble metal | $556.50 |
| D2950 | Core buildup | $73.80 |
| ADA Code | Endodontics | You Pay |
| D3220 | Therapeutic pulpotomy | $69.00 |
| D3310 | Root canal (anterior) | $329.00 |
| D3320 | Root canal (bicuspid) | $392.50 |
| D3330 | Root canal (molar) | $472.00 |
| ADA Code | Periodontics | You Pay |
| D4342 | Periodontal scaling and root planning (one to three teeth per quadrant) | $51.00 |
| D4341 | Periodontal scaling and root planning (four or more teeth per quadrant) | $102.00 |
| ADA Code | Prosthodontics | You Pay |
| Removable | ||
| D5110 | Complete denture - maxillary (upper) | $649.50 |
| D5120 | Complete denture - mandibular (lower) | $649.50 |
| D5213 | Maxillary partial denture (upper) - cast metal framework with resin denture bases | $950.00 |
| D5214 | Mandibular partial denture (lower) - cast metal framework with resin denture bases | $950.00 |
| Bridge | ||
| D6740 | Crown – porcelain/ceramic substrate(per unit) | $678.00 |
| D6750 | Crown - porcelain fused to high noble metal (per unit) | $750.00 |
| ADA Code | Oral Surgery | You Pay |
| D7111 | Extraction, coronal remnants - deciduous tooth | $80.00 |
| D7140 | Extraction, erupted tooth or exposed root | $74.00 |
| D7210 | Surgical removal of erupted tooth | $119.00 |
| D7220 | Removal of impacted tooth- Soft tissue | $134.00 |
| D7230 | Removal of impacted tooth- Partially Bony | $160.00 |
| D7240 | Removal of impacted tooth- Completely Bony | $172.50 |