goodhealthstartshere.org | deltadentalmo.com facebook.com/deltadentalmo @deltadentalmo odessa school...
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GoodHealthStartshere.org | DeltaDentalMO.com
facebook.com/DeltaDentalMO @DeltaDentalMO
Odessa School District
2015 Open Enrollment
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Broad Network Protection with Delta Dental
Selecting a Dentist
Delta Dental PPO &Delta Dental Premier Dentists
- Delta Dental Contracted Providers- Discounted Fees In-Network**- No Balance Billing- No Claim Forms- Delta Pays Dentist Directly
Non-Participating Dentists
- Not Under Contract With Delta Dental
- No Discounted Fees- Balance Billing is Possible- Dentists May Not File Claims- Delta Dental Pays Patient
**Delta Dental PPO providers typically offer the greatest discounts.
**Plan coverage is higher when you use a Delta Dental PPO provider.
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Delta Dental PPO ←Greatest Patient Savings Least Patient Savings→Delta Dental
PPO Network DentistDelta Dental
Premier Network Dentist
Non-Participating Dentist
Co-Insurance (Plan Pays)
Type A: Diagnostic and Preventive Services (exams, cleanings, x-rays, fluoride, sealants)
100% 80% 80%
Type B: Basic Restorative Services(fillings, extractions, periodontal maintenance)
80% 80% 80%
Type C: Major Restorative Services(periodontics, endodontics, crowns, dentures, bridges)
50% 50% 50%
Type D: Child Orthodontic Services (to age 19)
50% 50% 50%
Calendar Year Deductible $50 per person / $150 family limit
Applies to: B & C Services
Calendar Year Benefit Maximum $1,000 per person
Separate Lifetime Orthodontic Maximum $1,000 per eligible dependent child
Dependent Age Limit End of the calendar year in which your dependent turns 26
Benefit Overview – BASE PLAN
This is intended to be a summary. For more detailed information regarding covered services, limitations and exclusions consult your Summary Plan Description.
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Delta Dental PPO ←Greatest Patient Savings Least Patient Savings→Delta Dental
PPO Network DentistDelta Dental
Premier Network Dentist
Non-Participating Dentist
Co-Insurance (Plan Pays)
Type A: Diagnostic and Preventive Services (exams, cleanings, x-rays, fluoride, sealants)
100% 100% 100%
Type B: Basic Restorative Services(fillings, extractions, periodontal maintenance)
90% 80% 80%
Type C: Major Restorative Services(periodontics, endodontics, crowns, dentures, bridges)
60% 50% 50%
Type D: Child Orthodontic Services (to age 19)
50% 50% 50%
Calendar Year Deductible $50 per person / $150 family limit
Applies to: B & C Services
Calendar Year Benefit Maximum $1,500 per person
Separate Lifetime Orthodontic Maximum $1,000 per eligible dependent child
Dependent Age Limit End of the calendar year in which your dependent turns 26
Benefit Overview – BUY UP PLAN
This is intended to be a summary. For more detailed information regarding covered services, limitations and exclusions consult your Summary Plan Description.
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Questions?
Customer Service and Benefit Information
Call: 1-800-335-8266• Live reps from 7am to 5pm Monday through Friday• Benefit24 VRU (Virtual Response Unit)
-Faxback – summary of benefits
Email: [email protected]
Go online: www.deltadentalmo.com• Self-serve Subscriber features:• Online access 24/7• Search for a Network Provider• Track Use of Annual Maximum• Print/Request ID Cards• Claim Status and History• Copies of EOBs