Kaiser Permanente’s Small Group dental offerings present adult dental options that are highly complementary to our ACA-compliant embedded child dental plans and designed to work seamlessly with them. These plans are available as additions to our nation-leading health insurance plans and are consistent across Kaiser Permanente’s service area in Maryland, Virginia, and the District of Columbia.
All our Small Group dental plans share a robust PPO network that eliminates the need for referrals for specialist procedures. Per visit office visit charges have been eliminated, and there are no waiting periods, so members enjoy comprehensive dental benefits on Day One.
In addition, each of KP’s adult dental offerings ca be paired with optional enhanced cosmetic dental benefits, including full orthodontic services, implants, and more.
In Maryland and Virginia, employers can enhance the KP medical coverage they offer with one of the following dental options, available for purchase as riders (open available to those age 19 and older)*.
This plan offers the convenience of predictable costs, no deductibles, and no annual benefit maximums. Members pay a copay only for services that they receive – there is no charge for preventive care office visits. The plan includes comprehensive coverage of the full range of common dental procedures, including preventive, basic restorative, and major restorative services. Additional coverage for cosmetic dental procedures, including orthodontic treatments, implants, and veneers, can be purchased through the Kaiser Permanente OrthoPlus rider.
This is the new dental plan most similar to the Adult Dental HMO plan offered through Dominion Dental.
KP Smile SG Dental EPO Flyer (MD)
KP Smile SG Dental Copay Flyer (VA)
This plan gives members access to a curated, high-quality collection of in-plan providers, plus the freedom to see any licensed dentist outside of the plan. With in-plan dentists, members receive 80% coverage for preventive care procedures that include over 65% of services most frequently performed for adults. If members choose to visit a licensed dentist not included in the network of participating dentists, they receive 60% out -of-network coverage for preventive services.
The plan also includes coverage of basic restorative and major restorative services. Additional coverage for cosmetic dental procedures, including orthodontic treatments, implants, and veneers, can be purchased through the Kaiser Permanente OrthoPlus rider. The maximum annual benefit is $1,000, both in-plan and out-of-plan, and there is a $50 deductible per person.
KP Smile SG Dental PPO Basic flyer (MD)
KP Smile SG Dental C-POS Basic Flyer (VA)
This plan gives members access to a curated, high-quality collection of in-plan providers, plus the freedom to see any licensed dentist outside of the plan. With in-plan dentists, members receive 100% coverage for preventive care procedures that include over 65% of services most frequently performed for adults. If members choose to visit a licensed dentist not included in the network of participating dentists, they receive 80% out -of-network coverage for preventive services.
The plan also includes coverage of basic restorative and major restorative services. Additional coverage for cosmetic dental procedures, including orthodontic treatments, implants, and veneers, can be purchased through the Kaiser Permanente OrthoPlus rider. The maximum annual benefit covered is $1,500, both in-plan and out-of-plan, and there is a $25 deductible per person.
This is the new dental plan most similar to the PPO 1 / POS 1 plan offered through Dominion Dental.
KP Smile SG Dental PPO Flyer (MD)
KP Smile SG Dental C-POS Flyer (VA)
This plan gives members access to a curated, high-quality collection of in-plan providers, plus the freedom to see any licensed dentist outside of the plan. With in-plan dentists, members receive 100% coverage for preventive care procedures that include over 65% of services most frequently performed for adults. If members choose to visit a licensed dentist not included in the network of participating dentists, they receive 80% out -of-network coverage for preventive services.
The plan also includes coverage of basic restorative and major restorative services. Additional coverage for cosmetic dental procedures, including orthodontic treatments, implants, and veneers, can be purchased through the Kaiser Permanente OrthoPlus rider. The maximum annual benefit is $2,000, both in-plan and out-of-plan, and there is a $25 deductible per person.
This is the new dental plan most similar to the PPO 3 / POS 3 plan offered through Dominion Dental.
KP Smile SG Dental PPO High flyer (MD)
KP Smile SG Dental C-POS High Flyer (VA)
This plan combines the convenience of predictable costs with the freedom to see any licensed dentist. When they obtain care from an in-plan provider there are no deductibles and no annual benefit maximums. Members pay a copay only for services that they receive – there is no charge for preventive care office visits. If members choose to visit a licensed dentist not included in the network of participating dentists, they receive 80% out -of-network coverage for preventive services.
The plan also includes coverage of basic restorative and major restorative services. Additional coverage for cosmetic dental procedures, including orthodontic treatments, implants, and veneers, can be purchased through the Kaiser Permanente OrthoPlus rider. The maximum annual benefit is $2,000, both in-plan and out-of-plan, and there is a $50 deductible per person.
*Note: Limitations may apply to the availability of adult dental riders. Please contact your Kaiser Permanente representative for additional information.
The Kaiser Permanente Smile Kids program provides dental benefits that comply with the Essential Health Benefits provisions of the Affordable Care Act (ACA) for children aged 18 and younger. The program includes two plans. The KP Smile Kids Embedded Dental PPO is included with Kaiser Permanente’s Flexible Choice and Added Choice POS medical plans, which offer comprehensive out-of-network coverage. The KP Smile Kids Embedded Dental EPO is included with all other Kaiser Permanente medical plans.
Each of these dental offerings includes coverage for preventive, basic restorative, and major restorative services, with no need for referrals. Deductibles may apply depending on the provisions of the medical plan. Each of the plans also includes a medically necessary orthodontic benefit for children aged 18 and under. Additional coverage for cosmetic dental procedures, including orthodontic treatments, implants, and veneers, can be purchased through the Kaiser Permanente OrthoPlus rider.
KP Smile Kids SG Embedded Dental EPO (MD/DC)
Kids SG Embedded Dental PPO (MD/DC)
KP Smile Kids SG Embedded Dental Copay (VA)
KP Smile Kids SG Embedded Dental C-POS (VA)
Medically necessary orthodontic coverage for children under age 19 is included in Kaiser Permanente’s ACA-compliant health plans. This covers conditions such as cleft palate if associated with a medical diagnosis, with a referral from your Primary Care Physician.
Enhanced coverage for cosmetic dental procedures including implants, veneers, and orthodontic treatments like braces, is available for purchase through the Kaiser Permanente OrthoPlus rider, at an additional charge. When purchased with an adult dental plan, this rider covers all family members including children under age 19. It may also be purchased only for children as a supplement to the embedded pediatric dental benefit. There is a lifetime benefit limit of $1,000 per individual.
