SafeGuard Dental HMO *

Affordable Rates & Easy Payment Options

Texas

Annual

Monthly

Myself Alone
Myself & One
Myself & My Family

$145.20
$273.48
$415.80

$12.29
$23.16
$35.21

Example of Benefits

Procedure

Estimated
Typical Cost

Your Cost
with Plan

Savings

Resin-based (white) filling –
2 surfaces - anterior

$175

$35

$140

Complete upper denture

$1,645

$325

$1,320

Root planing & scaling

$256

$50

$206

Sealant (per tooth)

$45

$5

$40

Crown – porcelain fused to
base metal

$926

$245

$681

Extraction, erupted tooth

$135

$5

$130

 

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*Dental HMO thru, SafeGuard Dental HMO, PO Box 981987 , El Paso, TX 79998, Tel:1- 800-880-1800.