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Odessa School District Dental Benefits Effective July 1, 2014
•Opportunity to make changes/enroll
•Base & Buy-Up Plans
•Buy-Up plan includes a $1500 annual benefit maximum and 100% coverage for Diagnostic & Preventive Services in or out of PPO network
•Both plans continue to include access to both Delta Networks — Delta Dental PPO & •Delta Dental Premier
Selecting a Dentist
Delta Dental PPO and Delta Dental Premier Dentists
Delta Dental Contracted Provider Discounted Fees In-Network** No Balance Billing No Claim Forms Direct Dentist Reimbursement
**Discounts are deepest in the PPO network
Non-Network Dentists
Not Under Contract With Delta No Discounted Fees Balance Billing is Possible Not Obligated To File Claims Patient Reimburses Dentist
Network Status of Odessa Dentists:•Dr. Jerry Haney - Delta Dental PPO Network•Dr. Scott Heriford - Delta Dental PPO Network
Base Plan
Delta Dental PPO Network
Dentist
Delta Dental Premier Network
Dentist
Non-Network Dentist
Deepest Discounts
No balance billing
Discounts
No balance billing
No Discounts
Balance billing is possible
Co-Insurance (Plan Pays)
Diagnostic and Preventive Services 100% 80% 80%
Basic Restorative Services 80% 80% 80%
Major Restorative Services
50% 50% 50%
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
This is intended to be a summary only. Refer to the Dental Benefit Highlights document provided in your handout for more detail on services covered under each class and plan limitations.
Buy-Up Plan
Delta Dental PPO Network
Dentist
Delta Dental Premier Network
Dentist
Non-Network Dentist
Deepest Discounts
No balance billing
Discounts
No balance billing
No Discounts
Balance billing is possible
Co-Insurance (Plan Pays)
Diagnostic and Preventive Services 100% 100% 100%
Basic Restorative Services 90% 80% 80%
Major Restorative Services 60% 50% 50%
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
This is intended to be a summary only. Refer to the Dental Benefit Highlights document provided in your handout for more detail on services covered under each class and plan limitations.
Technology
1-800-335-8266• Live reps from 7am to 5pm Monday through Friday• Benefit24 VRU (Virtual Response Unit)
– Faxback – summary of benefits
[email protected]• Email your questions
www.deltadentalmo.com• Self-serve website
Questions?
Technology
Self-serve features:
–Network provider search–Claims status and history–Copy of EOB–Benefit design–Track use of maximums–Print ID cards –Request an ID card
www.deltadentalmo.com
