Class VI: Periodontal Gingivectomy Gingivioplasty Alveoplasty Vestibuloplasty 90% 10% 80% 20% Osseous Surgery After Deductible After Deductible After Deductible After Deductible Separate $250 Calendar Year Deductible to cross accumulate between classes VI, VII, IX No Annual or Lifetime Maximums apply Class VII: Oral Surgery Surgical Extractions of Impacted Teeth 90% 10% 80% 20% Separate $250 Calendar Year Deductible to cross After Deductible After Deductible After Deductible After Deductible accumulate between classes VI, VII, IX No Annual or Lifetime Maximums apply Class IX: Surgical Implants 90% 10% 80% 20% Separate $250 Calendar Year Deductible to cross After Deductible After Deductible After Deductible After Deductible accumulate between classes VI, VII, IX No Annual or Lifetime Maximums apply
Class VI: Periodontal Gingivectomy Gingivioplasty Alveoplasty Vestibuloplasty Osseous Surgery Separate $250 Calendar Year Deductible to cross accumulate between classes VI, VII, IX No Annual or Lifetime Maximums apply 90% After Deductible 10% After Deductible 80% After Deductible 20% After Deductible Class VII: Oral Surgery Surgical Extractions of Impacted Teeth Separate $250 Calendar Year Deductible to cross accumulate between classes VI, VII, IX No Annual or Lifetime Maximums apply 90% After Deductible 10% After Deductible 80% After Deductible 20% After Deductible Class IX: Surgical Implants Separate $250 Calendar Year Deductible to cross accumulate between classes VI, VII, IX No Annual or Lifetime Maximums apply 90% After Deductible 10% After Deductible 80% After Deductible 20% After Deductible
G00068AetnaActiveStaffMIPOptionCSummary.docx