Ambetter Dental & Vision

Ambetter offers Dental and Vision plans for individuals and families in Illinois.

Ambetter Health Insurance
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Coverage Area: Bond County, Calhoun County, Clinton County, Cook County, DuPage County, Greene County, Grundy County, Henry County, Jersey County, Kane County, Kankakee County, Kendall County, Lake County, Macoupin County, Madison County, Mercer County, Monroe County, Montgomery County, Randolph County, Rock Island County, St. Clair County, Washington County, Will County

Ambetter Adult Dental and Vision Benefits

Adult Dental* (19 years of age and older)

ServiceIn-NetworkOut-of-network
Routine Eye Exam100% CoveredNot Covered
Eyeglasses (frames)Covered up to $130Not Covered
Lenses (per pair)100% CoveredNot Covered
Contact Lenses (in lieu of glasses)Covered up to $130Not Covered

Adult Dental (19 years of age and older, does not include pediatric dental coverage)

Preventative and Diagnostic (Class 1) In-NetworkOut-of-network
Routine CleaningNo ChargeNot Covered
Oral ExamNo ChargeNot Covered
X-Ray – bite – wing, full-mouth and panoramic film No ChargeNot Covered
Minor Restorative (Class 2) In-NetworkOut-of-network
Minor Restorative – metal and resin-based fillings50% CoinsuranceNot Covered
Endodontic Therapy50% CoinsuranceNot Covered
Periodontics – scaling, root planning, and
periodontal maintenance
50% CoinsuranceNot Covered
Simple Extractions50% CoinsuranceNot Covered
Prosthodontics – relines, rebase, adjustment,
and repairs
50% CoinsuranceNot Covered
Major Restorative (Class 3) In-NetworkOut-of-network
Crowns and Bridges50% CoinsuranceNot Covered
Dentures50% CoinsuranceNot Covered
More Complex extractions and surgical services50% CoinsuranceNot Covered

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