Plan 65

Questions Regarding the Dental Option

How much is the dental option?
The 2015 monthly premium is $39.97.

Is there a waiting period?
Yes. There is a 12-month waiting period from the effective date of coverage for the following:

  • Crowns
  • Bridges
  • Dentures
  • Onlays
  • Dental implants
  • Oral/peridontal surgery

Does it cover dentures?
Yes, following a 12-month waiting period from the effective date of coverage. Dentures are covered at 50 percent following a $50 deductible and are subject to the annual benefit maximum per calendar year.

What if my dentist is not in the network?
If you use a non-contracting dentist, you will be reimbursed at 80 percent of the maximum allowable payment made to a contracting dentist for the same service. But you may need to pay for any charges over the dental plan's allowance in addition to any deductible and coinsurance of the program.

Can I cancel the dental policy at a later time?
Yes.

Can I get the dental policy at a later time?
No, the dental policy is only offered at your initial enrollment in a Plan 65 policy.

What does it cover?
It covers 100 percent of the cost for two oral exams per year; two cleaning, scaling and polishings per year; two bitewing x-rays per year; and one full-mouth x-ray every five years. It covers 80 percent after a $50 annual deductible on simple extractions, fillings (except gold), root canal treatment, periodontic treatment of the gums, extraction of impacted teeth, and general anesthesia with a covered service.

Following a 12-month waiting period, services for crowns, bridges, dentures, onlays, dental implants and oral/periodontal surgery are covered at 50 percent following a $50 annual deductible. All services are subject to an annual maximum benefit payment of $1,500 per calendar year.

Does it have a deductible?
There is a $50 annual deductible on some services.

Does the deductible apply to the two yearly checkups?
No, your two yearly checkups are covered at 100 percent.

Can I just get the dental plan?
Yes, but only during our dental open enrollment period.

 

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