The following chart reflects a summary of the coverage for information purposes only. Please refer to the Plan Document for detailed coverage including limitations and exclusions.
We Have a Total Of 3 Insurance Plans
Penn Dental Plan for University Employees and DependentsPFP Dental Plan for Faculty & Staff of the University of Pennsylvania.
Maximum Annual Coverage Per Individual: $3,000.
Insurance Plan Coverage
Coverage100%
Diagnostic & Preventive Care
Routine examinations and prophys/cleanings (twice annually), Radiographs, fluoride applications and sealants (for children up to age 14).
Coverage100%
Restorative Care
Composites (tooth-colored fillings); co-pays may apply on certain procedures.
Coverage100%
Oral Surgery
Typically covered under your medical plan; for complex extractions, a co-pay may apply.
Coverage80%
Endodontics & Periodontics
Endo: Root canal therapy, pulp treatment, pulpotomy, apicoectomy. Perio (gum treatment): Surgical and non-surgical periodontics including subgingival curettage, scaling and root planing, periodontal maintenance.
Coverage60%
Prosthodontics
Crowns, bridges, inlays, and dentures
Coverage50%
Implant Surgery
Implant surgery is covered at 50% and crown restoration is covered at 60%. Other components not covered such as bone & abutment may be required.
Coverage60%
Orthodontics (adult & child) – including Invisalign
One orthodontic treatment per lifetime for children and adults, subject to a maximum $2,000 benefit.
Coverage50%
Cosmetic & Occlusal Nightguards
Bleaching is excluded from the Cosmetic benefit, although the fee has been significantly reduced. Occlusal Nightguards limited to 1 in 5 years.
Penn Dental Plan for UPHS Employees and DependentsDental Plan for University of Penn Health System Employees and Dependents.
Maximum Annual Coverage Per Individual: $3,000.
Annual Deductible: $50/person ($150/family)
Insurance Plan Coverage
Coverage100%
Diagnostic and Preventive Care
Routine examinations and prophys/cleanings (twice annually), Radiographs, fluoride applications and sealants (for children up to age 14).
Coverage80%
Restorative Care
Composites (tooth-colored fillings); co-pays may apply on certain procedures.
Coverage80%
Oral Surgery
Typically covered under your medical plan; for complex extractions, a co-pay may apply.
Coverage80%
Endodontics & Periodontics
Endo: Root canal therapy, pulp treatment, pulpotomy, apicoectomy. Perio (gum treatment): Surgical and non-surgical periodontics including subgingival curettage, scaling and root planing, periodontal maintenance.
Coverage50%
Prosthodontics
Crowns, bridges, inlays, and dentures
Coverage50%
Implant Surgery
Implant surgery is covered at 50% and crown restoration is covered at 60%. Other components not covered such as bone & abutment may be required.
Coverage60%
Orthodontics (adult & child) – including Invisalign
One orthodontic treatment per lifetime for children and adults, subject to a maximum $2,000 lifetime benefit.
Coverage50%
Occlusal Nightguards
Occlusal Nightguards limited to 1 in 5 years.
Penn Dental Plan for Students of the University of PennsylvaniaDental Plan for Sudents of the University of Penssylvania.
Maximum Annual Coverage Per Individual: $1,500.
Annual Coverage Per Individual: $1,500 / Annual Premium Cost: $429 / Annual Deductible: $50
Insurance Plan Coverage
Coverage100%
Diagnostic and Preventive Care
Routine examinations and prophys/cleanings (twice annually), Radiographs, fluoride applications and sealants (for children up to age 14).
Coverage80%
Restorative Care
Composites (tooth-colored fillings); co-pays may apply on certain procedures.
Coverage80%
Oral Surgery
Typically covered under your medical plan; for complex extractions, a co-pay may apply.
Coverage80%
Endodontics & Periodontics
Endo: Root canal therapy, pulp treatment, pulpotomy, apicoectomy. Perio (gum treatment): Surgical and non-surgical periodontics including subgingival curettage, scaling and root planing, periodontal maintenance.
Coverage50%
Prosthodontics
Crowns, bridges, inlays, and dentures
Coverage50%
Implant Surgery
Implant surgery is covered at 50% and crown restoration is covered at 50%. Other components not covered such as bone & abutment may be required
Coverage50%
Orthodontics – including Invisalign
One orthodontic treatment per lifetime for children and adults, subject to a maximum $1,500 benefit.
Coverage50%
Occlusal Nightguards
Occlusal Nightguards.