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Benefits & coverage

SmileWay® Wellness Benefits

Your plan offers expanded dental coverage at no additional cost to you if you have been diagnosed with certain chronic conditions that affect your oral health.

Qualifying conditions

Conditions that qualify for SmileWay Wellness Benefits are:

  • Amyotrophic lateral sclerosis (ALS)
  • Cancer
  • Diabetes
  • Heart disease
  • HIV/AIDS
  • Huntington's disease
  • Joint replacement
  • Kidney disease (chronic)
  • Lupus
  • Opiod misuse and addiction
  • Organ transplant or on transplat list
  • Parkinson's disease
  • Rheumatoid arthritis
  • Sjögren's syndrome
  • Stroke

Additional benefits

When you opt into SmileWay Wellness Benefits, you'll receive these added benefits per calendar or contract year, covered at 100%*.

100% Covered benefitDescriptionCodes
One periodontal scaling and root planing per quadrantDeep cleaning below the gum lineD4341, D4342
And up to four of the following procedures (any combination):
Prophylaxis — adultTeeth cleaning — adultD1110
Prophylaxis — childTeeth cleaning — childD1120
Periodontal maintenanceTreatment for inflammation or infectionD4910
Scaling in presence of moderate or severe gingival inflammationPlaque removalD4346

** SmileWay Wellness Benefits are subject to any applicable maximums and deductibles under the terms and conditions outlined in your Evidence of Coverage. Please review your plan booklet for specific details about your coverage.

Members

Dependents with chronic conditions are also eligible for SmileWay Wellness Benefits, but dependents over 18 must opt in themselves.

Quin Parker

Primary member

Not enrolled

Contact your benefits administrator to opt in to SmileWay Wellness Benefits.

Riley Parker

Adult dependent

Riley Parker is an adult dependent. You must be authorized to view this information.