ASBA - Dental & Vision Benefits For Seniors In Texas

Dental Plans That Fit Your Budget

Keep your dentist or choose an In-Network dentist and save
Over 400,000 providers to choose from, whether home or away
No waiting period on covered services – get access right away
Covers exams, cleanings, fillings, crowns, implants, and more
High annual maximum

Premier Dental Plan

Member Only

$48.27/month

Member +1

$96.63/month

Member + Family

$122.88/month

Deductible:

(per visit & per person)

$20

Annual Maximums:

(per year & per person)

$5000

Preventative SERVICE:
Covers up to 100%

Bitewing X-rays
Panoramic X-Rays
Routine Cleanings
Routine Oral Exams

Basic SERVICE:

Denture Repair (maxillary) - $51
Fillings (2 surface amalgam) - $51
Fillings (2 surface resin) - $61
Sealants (per tooth) - $17

Major SERVICE:

Crown (full cast noble metal) - $245
Crown Repair - $47
Denture (maxillary) - $302
Extraction (complex) - $114
General Anesthesia - $35
Implants - $1648
Root Canal (molar tooth) - $261

Use your current dentist OR Save 25-50% with a dentist in our network. Find a dentist
(note: Enter zip, select city & state, and Classic PPO network.)

This highlight is not a certificate of insurance or a guarantee of coverage. Premium rates may change upon renewal and can be adjusted for the entire group or a specific class. A class is defined in the group policy. Benefits are subject to change upon agreement between the carrier and the participating organization. The policy is renewable at the option of the insured.

A Vision Plan With A Clear Difference

Get quality coverage on the vision services you need:

Thousands of eye doctors nationwide
Covers in & out of network
Eyeglasses, contact lenses and more

Vision Plan Comparison	Base Plan	Base Plus Plan	Premium Plan	Enhanced Plan
Member Only	$12.72 /month	$14.70 /month	$19.00 /month	$21.95 /month
Member +1	$22.30 /month	$28.12 /month	$34.00 /month	$37.79 /month
Member + Family	$27.75 /month	$31.25 /month	$42.00 /month	$47.00 /month
Exam Copay	$15.00	$15.00	$15.00	$15.00
Glasses Copay	$25.00	$25.00	$25.00	$25.00
Frames Allowance	$150.00	$150.00	$180.00	$200.00
Featured Frames Allowance	$170.00	$170.00	$200.00	$220.00
Contacts Allowance	$150.00	$150.00	$160.00	$200.00
Frames	Every 24 months	Every 24 months	Every 24 months	Every 12 months
Lenses	Every 12 months	Every 12 months	Every 12 months	Every 12 months

Lens Benefits	Base Plan	Base Plus Plan	Premium Plan	Enhanced Plan
Single Vision, Lined Bifocal, and Lined Trifocal Lenses	Yes	Yes	Yes	Yes
100% Coverage On Progressive Lenses	Only Standard	All	All	All
Anti-Glare Coating	30%	30%	$25	100%
Light-reactive Lenses	30%	30%	30%	100%

WellVision Exam every 12 months.
Contact Lens Exam every 12 months
Glasses with a $25 copay, 20% savings on additional glasses.
Lenses every 12 months: 100% coverage on most
Up to 30% savings on anti-reflective & UV coating
Additional Savings: 20% savings on additional glasses, 15% savings on contact lens exam, contact lens rebates and more!
Find Your Eye Doctor

Plus generous out-of-network reimbursements

Exam up to $45
Lined Trifocal Lenses up to $65
Frame up to $70
Progressive Lenses up to $50
Single Vision Lenses up to $30
Contacts up to $105
Lined Bifocal Lenses up to $50
Medically Necessary Contact Lenses up to $210

Dental Plan: Ameritas Life Insurance Corp (Ameritas Life) from $/month
Vision Plan: Vision Service Provider (VSP) from $/month
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Quality plans for members like you,featuring:

Premier Dental Plan

Quality plans for members like you,
featuring: