Benefit Application for Dental
APPLICATIONS MUST BE COMPLETE OTHERWISE THEY WILL NOT BE PROCESSED
All applications will be processed according to the date the it is received in our office. Your claim must show the amount paid by your insurance company, if applicable.
The maximum amount paid per Tribal Member for Dental Claims:
*Treatment - $1,500.00 Per Year
*Braces - $1,500.00 Per Lifetime
*Dentures - $1,500.00 Per Fiscal Year