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2/21/07
Understanding Your Dental Plan Benefits
Did you know that UC pays 100% of your monthly UC sponsored Dental Plan premiums for eligible employees and your eligible family members! You have a choice between Delta Dental Plan and PMI Dental Plan. Both plans cover a wide range of preventative and treatment services. The complete explanation of benefits, including exclusions and limitations is included in the dental plan EOC books. (You can switch plans during the November Open Enrollment period if you are not satisfied with your current plan).
No. Delta Dental has two provider networks: Delta PPO (preferred provider organization) and Delta Premier (managed fee-for-service program). All Delta dentists participate in the Premier plan, but not all Delta dentists are part of the PPO plan.
PPO dentists agree to provide treatment at reduced fees, which means your share of the bill will be less (co-payments and other fees). You can either ask the dentist if they are a PPO provider or check on the Delta Dental website. Before beginning any treatment or having a procedure done, contact your dental plan for specific information about coverage. If you have Delta Dental, for any claim anticipated to be over $400, ask for a predetermination of costs to be sure of the coverage level.
Yes. However, you need to pay the dentist directly and then file a claim with Delta. Delta cannot assure what percentage of the charges will be covered.
Dental services are only covered if you visit your PMI provider. When you enroll in the plan you can select or are assigned to a participating dentist near your home. The network of PMI dentists is much smaller than the Delta Dental network. If you are considering selecting this plan for the first time, confirm that your dentist participates in the plan.