|
| |
DENTAL PLAN
by Tony Balsamo
The dental plan has been approved by membership vote for another three
years. Delta Dental administers our
dental program. Starting
November 1, 2007
, the plan has changed. Benefits and covered dental
services are as follows:
The first change is we now have a
maximum benefit per family member of $2000 year.
The second change we have is that dental
implants are added to our proshthodonics service and covered there.
Our third change we have is that there
is now a $10
co-pay per day for a visit to the dentists office. Also keep in mind that we still have 2 exams and 2 cleanings per year.
Effective November 1, 2007, benefits will be paid for the fee charged by
the dentist up to 100% of the usual, customary and reasonable charge for
Diagnostic, Preventive, Endodontic, Periodontic, and Oral Surgical procedures,
80% for Restorative procedures and 50% for the Prosthodontic and Orthodontic
procedures listed in Schedule A, made a part hereof by reference, which include,
but are not limited to, the following:
|
Type
of Service
|
Delta
Dental Pays
|
Description
|
|
Diagnostic
|
100%
|
Examinations, x-rays, study models
|
|
Preventative
|
100%
|
Cleaning of teeth, application of fluoride solutions
to teeth, space maintainers when necessary for children who prematurely
lose their first teeth and sealants.
|
|
Minor
Restorative
|
100%
|
Fillings using silver or resin (tooth colored)
materials, including fillings placed after a nerve is removed from a
tooth.
|
|
Major
Restorative
|
80%
|
Cast restorations, crowns, caps and jackets, are
covered benefits when fillings cannot restore teeth satisfactorily. The
type of material (gold, porcelain, etc.) that is covered at 80% is based
on the location of the tooth.
|
|
Endodontics
|
100%
|
Treatment of the nerve canal in a tooth (e.g., root
canal therapy).
|
|
Periodontics
|
100%
|
Treatment of disease of the gums, and bone-related
diseases of the supporting structures of the teeth.
|
|
Oral
Surgery
|
100%
|
Surgical procedures, including simple extractions,
and removal of impacted teeth.
|
|
Prosthodontics
|
50%
|
Installation and replacement of fixed bridgework,
partial dentures and complete dentures. Replacement of an existing partial
denture or fixed bridgework is a covered benefit only if the existing
denture or bridge is at least seven years old and cannot be made
serviceable.
|
|
Orthodontics
|
50%
|
Treatment for the prevention and correction
(straightening) of malposed teeth for dependent children under age 19.
|
Benefits will also be paid to a licensed dentist for such eligible charges
which are for treatment of a fractured jaw or of accidental injuries to natural
teeth within twelve (12) months of the accident (including replacement of such
natural teeth within such period).
|
