BlueMedicare HMO Benefit Schedule for. Dental Care Services Hearing Services Vision Care Services.
|
|
- Peter Holt
- 6 years ago
- Views:
Transcription
1 BlueMedicare HMO 2017 Benefit Schedule for Dental Care Services Hearing Services Vision Care Services A Medicare Advantage Dental, Hearing and Vision Benefit Health coverage is offered by Blue Cross and Blue Shield of Florida, Inc., D/B/A Florida Blue, an Independent Licensee of the Blue Cross and Blue Shield Association. Y0011_ CMS Accepted
2 Dental Care Services Taking care of your health includes caring for your teeth, too. In fact, your dental health can have a direct impact on your overall health and well-being, and may have an influence on the development of certain conditions such as diabetes and heart disease. Easy access to preventive dental care is one of the most important things we can provide. That s why members never need a referral or pre-authorization to visit an In-Network dentist. Networks are comprised of independent contracted dentists. To find an In-Network dentist in your area visit www. BlueMedicareFL.com or call toll-free or TTY As a BlueMedicare member, you have access to a large network of providers. Exams and X-rays are covered each year when you receive services from an In-Network dentist. Follow the column in the table that has your plan name for a list of the covered services under your BlueMedicare dental plan. BlueMedicare HMO LifeTime, and Select In-Network Out-of-Network In-Network Plus Calendar Year Maximum Not Applicable $1,000 Preventive Services Periodic Oral Examination (D0120) - up to 1 every 6 months Periodic Oral Examination (D0140, D0145) - up to 1 every 6 months Comprehensive Oral Examination (D0150) Out-of- Network 1 per lifetime, per dentist up to 1 every 6 months Cleaning (D1110) 1 every 6 months Scaling and Root Planing, per quadrant (D4341, D4342) $55 copay Full Mouth Debridement (D4355) $20 copay Periodontal Maintenance 2 every 12 months $10 copay Bitewing X-rays (D0270, D0272, D0273, D0274, D0277) Full-mouth X-rays (D0210 or D0330) 1 set every 12 months 1 set every 36 months 1 set every 6 months 1 set every 12 months 2
3 Dental Care Services (continued) Additional Services Simple Extraction (D7140) for an erupted tooth OR exposed root Surgical Extraction (D7210, D7220, D7230, D7240, D7250, D7251) - up to 3 per year Complete Denture (including Routine Post- Delivery Care) (spare dentures not covered) (D5110) - 1 every 5 years Complete Bottom Denture (including Routine Post-Delivery Care) (spare dentures not covered) (D5120) - 1 every 5 years BlueMedicare HMO LifeTime, and BlueMedicare HMO MyTime Select In-Network Up to 2 per year 3 Out-of- Network Plus In-Network $35 copay Up to 3 per year Out-of- Network $75 Copay $195 Copay $195 Copay Upper Partial Dentures (D5211, D5213) $195 Copay Lower Partial Dentures (D5212, D5214) $195 Copay Crowns (D2710, D2740, D2750, D2751, D2752, D2790, D2791, D2792) 1 every 12 months $195 Copay Re-cement Crown (D2920) $10 Copay Sedative Filing $10 Copay Amalgam Restorations 4 per year $20 Copay Resin-Based Composite Restorations -including posterior composites (D2330, D2331, D2332, D2335, D2391, D2392, D2393, D2394) 4 per year Denture Adjustment Complete or Partial (D5410, D5411, D5421 or D5422) up to 2 per year $20 Copay $25 copay Denture Repairs (D5610, D5620, D5630) $25 Copay Denture Relines (D5730, D5731, D5740, D5741, D5750, D5751, D5760, D5761) - 1 per year; not covered within 6 months of initial denture placement or on spare dentures. $25 Copay
4 Dental Care Services (continued) Your request for reimbursement can be sent to: Florida Combined Life PO Box 1047 Elk Grove Village, IL Florida Combined Life Insurance Company, Inc. is responsible for the administrative functions of the BlueMedicare dental program. If you have an inquiry, call Monday through Friday, 8:00 am to 8:00 pm ET. Toll-free: or TTY If you have a grievance or appeal, submit it in writing to: Florida Blue HMO Attn: Medicare Advantage Member Appeals PO Box Jacksonville, FL
5 Hearing Services If you find that your hearing isn t as good as it used to be, you can rest assured that your BlueMedicare plan can offer you assistance. Under your plan, you have coverage for a comprehensive hearing exam and exclusive savings on hearing devices. Routine Hearing Exam evaluation and fitting once per year Hearing Aids - Up to two TruHearing Flyte hearing aids every year (one per ear, per year). Benefit is limited to the TruHearing Flyte 700 and Flyte 900 hearing aids, which come in various styles and colors. You must see a TruHearing provider to use this benefit. Hearing aid purchases include: 3 provider visits within first year of hearing aid purchase 45-day trial period 3-year extended warranty 48 batteries per aid BlueMedicare HMO LifeTime, and Select 5 Plus In-Network Out-of-Network In-Network Out-of-Network $45 Copay Flyte 700- $699 Copay Flyte 900- $999 Copay This coverage is automatically included in your plan as long as you use our partner, TruHearing. TruHearing offers a national network of providers. All appointments must be scheduled through them. Call TruHearing today at or TTY to start saving! Follow the column in the table that has your plan name for a list of the covered services under your BlueMedicare hearing plan. Benefit does not include or cover any of the following: ear molds, hearing aid accessories, additional provider visits, extra batteries, hearing aids that are not the TruHearing Flyte 700 or Flyte 900, hearing aid returns fees and loss and damage warranty claims. Costs associated with excluded items are the responsibility of the member and are not covered by the plan. TruHearing is responsible for the administrative functions of the BlueMedicare hearing program. If you have an inquiry, call TruHearing at or TTY Their hours of operation are: February 15 through September 30-8:00 am to 8:00 pm ET, Monday through Friday; and October 1 through February 14-8:00 am to 8:00 pm ET, seven days a week.. However, discounts for hearing exams and hearing aids and batteries are available under the Blue365 Member Discount Program.* If you have a grievance or appeal, submit it in writing to: Florida Blue Attn: Medicare Advantage Member Appeals PO Box Jacksonville, FL
6 Vision Care Services Florida Blue HMO understands that you want your vision to be the best it can be. That s why we have included a vision benefit in your BlueMedicare plan. We encourage you to have your eyes examined each year. Eye diseases such as glaucoma can be caught early with a regular checkup. If you have diabetes, an annual eye exam is important for the health of your eyes. To find eye professionals in your area visit or call toll-free BlueMedicare HMO LifeTime,, Plus and Select Routine Eye Exam - 1 per year, including dilation when necessary Spectacle Lenses 1 pair covered every 12 months Clear Plastic Lenses (Single Vision, Lined Bifocal, Trifocal or Lenticular) 6 In-Network Out-of-Network $20 copay Other Lenses - In addition to the spectacle lens member charge. Lenses are covered in full after both the basic and other lens charges. Oversize lenses Polycarbonate $35 copay Polycarbonate when medically necessary (+/ diopters or greater) Progressive Lenses $65 Copay Premium Progressive (Varilux, etc.) $105 copay Ultra Progressive $140 copay Intermediate-Vision $30 copay Blended Segment $20 copay High-Index $60 copay Polarized $75 copay Photochromic Glass $20 copay Plastic Photosensitive $70 copay Coatings - Member charges in addition to the spectacle lens member charge Tinting of plastic lenses $15 copay Scratch-Resistant Ultraviolet $15 copay Anti-Reflective (AR) Standard $40 copay Anti-Reflective (AR) Premium $55 copay Anti-Reflective (AR) Ultra $69 copay
7 Vision Care Services (continued) BlueMedicare HMO LifeTime,, Plus and Select In-Network Scratch Protection Plans - Member charges in addition to the spectacle lens member charge Out-of-Network Single Vision lenses $20 copay Multifocal lenses $40 copay Frames 1 every 24 months Collection Frames Fashion level Not Applicable Collection Frames Designer level $15 copay Not Applicable Collection Frames Premier level $40 copay Not Applicable Non-Collection Frames additional discounts not available at Sam s Club or Wal-Mart Up to a $100 allowance then 20% discount on overage Contact Lenses - in lieu of spectacle lenses and frames every 12 months Standard and Specialty lenses Includes evaluation, fitting and follow-up care. Additional discounts not available at Sam s Club or Wal-Mart Up to a $100 allowance then 15% discount on overage Medically Necessary lenses (+/ diopters or greater) Low-Vision Benefits - Your vision provider must obtain prior authorization for any Low-Vision benefits Low-Vision Evaluation 1 comprehensive evaluation every 5 years Low-Vision Follow-Up Care - 4 visits in any 5 year period Low-Vision Aids (i.e. magnifiers) Additional Discounts Laser Correction Surgery (i.e. Lasik) Plan pays up to $300 maximum member reimbursement. Member pays all overage Plan pays up to $100 per visit Plan pays up to a $600 annual or $1,200 lifetime member reimbursement. Member pays all overage. 25% off provider s normal rates or a 5% discount on any in network advertised specials No Discount 7
8 Vision Care Services (continued) Your request for reimbursement can be sent to: Vision Care Processing Unit P.O. Box 1525 Latham, NY Davis Vision is responsible for the administrative functions of the BlueMedicare vision program. Call or TTY seven days a week: Monday-Friday, 8 am -11 pm, Saturday, 9 am - 4 pm, Sunday, 12 pm - 4 pm ET. Automated help is available 24/7 by calling If you have a grievance or appeal, submit it in writing to: Florida Blue HMO Attn: Medicare Advantage Member Appeals PO Box Jacksonville FL The amount you spend on copays and coinsurance for the dental, hearing and vision services in this benefit schedule will not go toward meeting the annual maximum out-ofpocket under a BlueMedicare Advantage HMO plan. *Blue365 offers access to savings on items that members may purchase directly from independent vendors. Blue365 does not include items covered under your policies with Florida Blue or any applicable federal health care program. To find out what is covered under your policies, call Florida Blue. Blue Cross and Blue Shield Association (BCBSA) may receive payments from Blue365 vendors. Neither BCBSA nor any local Blue company recommends, endorses, warrants or guarantees any specific Blue365 vendor or item. For more information about Blue365, go to Florida Blue HMO is an HMO Plan with a Medicare contract. Enrollment in Florida Blue HMO depends on contract renewal. This information is available for free in other languages. Please call our Customer Service number at (TTY users should call ) Hours are 8 a.m. - 8 p.m. local time, seven days a week from October 1 to February 14, except for Thanksgiving and Christmas. From February 15th to September 30th, we are open Monday - Friday, 8 a.m. - 8 p.m., local time. Esta información está disponible de manera gratuita en otros idiomas. Comuníquese con Atención al cliente al ( Usuarios de equipo telescritor TTY llamen al ) Estamos abiertos de 8 a.m. a 8 p.m. hora local los siete días de la semana, desde el 1 de octubre hasta el 14 de febrero, excepto el día de Acción de Gracias (Thanksgiving) y el día de Navidad. Desde el 15 de febrero al 30 de septiembre, estamos abiertos de lunes a viernes de 8:00 a.m. a 8:00 p.m. hora local. 8
2015 Individual Adult Dental and Vision Care Plan Overview
2015 Individual Adult Dental and Vision Care Plan Overview Take care of your health with Adult Vision Care and Dental plans Adult Vision Care and Dental plans through Independence Blue Cross (Independence)
More informationAldine ISD. Do not pay high premiums for dental benefits pay for your services when and if used. It just makes good financial sense!
Aldine ISD The QCD of America Dental & Vision Benefit Program (QCD) is a managed cost program offering a large selection of highly qualified private practice dental and optical professionals. The QCD Philosophy
More informationCypress-Fairbanks ISD
Cypress-Fairbanks ISD The QCD of America Dental & Vision Benefit Program is a managed cost program offering a large selection of highly qualified private practice dental and optical professionals. The
More information2016 Individual Specialty Products Overview. Dental Vision Travel
2016 Individual Specialty Products Overview Dental Vision Travel 1 DENTAL VISION TRAVEL Protect your health with specialty plans Beyond medical, Independence Blue Cross (Independence) offers vision and
More informationWelcome to the Future of Dental & Vision Benefits Today!
The QCD of America Dental & Vision Benefit Program is a managed cost program offering a large selection of highly qualified private practice dental and optical professionals. The QCD Philosophy QCD believes
More informationAnthem Extras Packages
Anthem Extras Packages Dental, Vision and more California Benefits that complement your Medicare Supplement plan Packaged benefits better together Healthy teeth and eyes help contribute to your overall
More informationAnthem Extras Packages
Anthem Extras Packages Dental, Vision and more Virginia Benefits that complement your Medicare Supplement plan Packaged benefits better together Healthy teeth and eyes help contribute to your overall well-being.
More informationdental and vision plans
dental and vision plans for AVMA LIFE members and their staff Administered by Delta Dental of Illinois A dental and vision plan is a great way to support your oral and eye health, as well as your overall
More informationThe Individual Dental & Vision Benefit Program
The Individual Dental & Vision Benefit Program Please complete the enrollment form(s) and return to: 751 E. Southlake Blvd., Suite 120 Southlake, Tx 76092 751 E. Southlake Blvd. Suite 120, Southlake, Tx
More informationDo Not Pay High Premiums for Dental Benefits Pay for Your Services When and If Used. It Just Makes Good Financial Sense!
The QCD of America Dental & Vision Benefit Program (QCD) is a managed cost program offering a large selection of highly qualified private practice dental and optical professionals. The QCD Philosophy QCD
More informationST. CHARLES COMMUNITY SCHOOLS Dental Benefits Plan
PO Box 610 Southfield, MI 48037 248-901-3705 ST. CHARLES COMMUNITY SCHOOLS Dental Benefits Plan Class 2 - Financial Assistant, Secretaries with Medical The Plan-at-a-Glance PPO Networks: ADN Dental Network,
More informationSmile for Health Value Plans
Smile for Health Value Plans Affordable dental plan solutions ERC-0150-0516 Smile for Health Value Plans Improved PPO plans Whether you need dental and vision benefits to complete your health care package
More informationAubrey ISD. Dental Select Plan Rates for: For the benefit period running 09/01/2017 through 08/31/2018
Dental Select Plan Rates for: For the benefit period running 09/01/2017 through 08/31/2018 Indemnity Platinum Network Employee $37.54 Emp + 1 $70.88 Emp + Family $118.67 Summary of Benefits For: 80th R&C
More informationBlackwater Communications Inc.
Blackwater Communications Inc. Consumer Driven Choices Monthly Employee Rates Employee Only Employee + One Employee + Family RED PLUS Employer Paid $10.00 $20.00 A Limited Reimbursement Program Calendar
More informationDo not pay high premiums for dental benefits pay for your services when and if used. It just makes good financial sense!
Houston ISD The QCD of America Dental & Vision Benefit Program is a managed cost program offering a large selection of highly qualified private practice dental and optical professionals. The QCD Philosophy
More informationSmile for Health PPO Plans. Value Portfolio. Combine dental and vision benefits for one affordable price
Smile for Health PPO Plans Value Portfolio Combine dental and vision benefits for one affordable price Protecting More Than Just Your Smile The eyes and mouth are pathways to the body. That s why vision
More informationAnthem Extras Packages
Anthem Extras Packages Dental, Vision and more Ohio benefits that complement your Medicare Supplement plan Dental coverage You might pay more when you visit an out-of-network dentist Packaged benefits
More informationFee $20 $30 $60 $35 $65 $55 $45 $15 $30. Fee $55 $75 $85 $105 $60 $80 $115 $80 $105 $140 $170 $875 $135 $155 LENS OPTIONS. Fee $500 $600 $700
Dental Savings Schedule (General Dentist) *Dentists may add additional lab fees to discounted services with*. DIAGNOSTIC & PREVENTATIVE D0120 Periodic Oral Evaluation D0150 Comprehensive Oral Evaluation
More information2017 Dental Options BALTIMORE CITY PUBLIC SCHOOLS. Baltimore City Public Schools 2017 Dental Options C1
2017 Dental Options BALTIMORE CITY PUBLIC SCHOOLS Baltimore City Public Schools 2017 Dental Options C1 Table of Contents Important Information for 2017... 1 Dental HMO (DHMO)... 2 Preferred Dental PPO
More informationDental insurance is important. It s a fact.
Dental insurance is important. It s a fact. www.deltadentalco.com Fact: Your health could be at risk. Yes, it s true. Your overall health may be impacted by your oral health. Researchers have uncovered
More information2018 Presbyterian Health Plan Federal Employee Dental & Vision Options
2018 Presbyterian Health Plan Federal Employee Dental & Vision Options For more information: 1804 Juan Tabo NE, Suite A, Albuquerque, NM 87112 888 862 8659 505 237 1501 benefitsource.org These benefits
More informationHMO INSERT TO 2019 EVIDENCE OF COVERAGE
Optima Medicare HMO INSERT TO 2019 EVIDENCE OF COVERAGE Chapter 4, Section 2.2 on Extra optional supplemental benefits you can buy Dental Optional Supplemental Benefits Optima Medicare offers some extra
More informationDental Options 2018 BALTIMORE CITY PUBLIC SCHOOLS
Dental Options 2018 BALTIMORE CITY PUBLIC SCHOOLS Contents Important Information for 2018... 1 Dental HMO (DHMO) Dental Plan... 2 Preferred Dental PPO (DPPO) Dental Plan... 3 Summary of Dental PPO Benefits...
More informationHERE IS A SUMMARY OF YOUR NEW VISION BENEFIT PACKAGE
HERE IS A SUMMARY OF YOUR NEW VISION BENEFIT PACKAGE TEAMSTERS LOCAL 72 and the New York State Thruway Authority is pleased to offer you a vision plan administered by Davis Vision. WHAT ARE THE PLANS BENEFITS?
More informationAnthem Extras Packages for Seniors
Anthem Extras Packages for Seniors Talking Points and Frequently Asked Questions FOR VIRGINIA Background Anthem is proud to announce the availability of Anthem Extras Packages for Seniors, providing coverage
More informationDanJack Enterprises, Inc., d/b/a Business Resource Services (BRS) FUSION Highlight Sheet
Plan 1 Effective Date: 1/1/2019 FUSION: THE ULTIMATE CHOICE SM combines dental and eye care benefits in one easy-to-administer plan. This plan combines the annual maximum between the dental and eye care
More informationDelta Dental of Wisconsin 2016 Open Enrollment Materials. For AFSCME Council 32
Delta Dental of Wisconsin 2016 Open Enrollment Materials For It s open enrollment time. Follow the steps to edit your current coverage or enroll in the plan. If you are currently enrolled and do not have
More informationAffordable dental plan and package options for Medicare Supplement plan members
Last updated: January 2019 Affordable dental plan and package options for Medicare Supplement plan members Blue Shield of California rates effective: April 1, 2018 blueshieldca.com Something to smile about
More informationBaltimore City Public Schools 2013 Dental Options
Baltimore City Public Schools 2013 Dental Options Baltimore City Public Schools Important Phone Numbers for 2013 DHMO Customer Service (410) 847-9060 or (888) 833-8464 DHMO Mailing Address The Dental Network
More informationPediatric Dental and Vision
Individual & Family Plans (IFP) and Small Business Group (SBG) Health Net of California, Inc. (Health Net) Pediatric Dental and Vision Andre Hamil Health Net When you purchase a Health Net PureCare HSP
More informationAffordable dental plan and package options for Medicare Supplement plan members
Last updated: December 2017 Affordable dental plan and package options for Medicare Supplement plan members Blue Shield of California rates effective: April 1, 2018 blueshieldca.com Something to smile
More informationcommunity Health Plans
About Us Community Health Plans (CHP) is the fastest growing discounted dental and vision savings program with a national network of participating providers. We are the only free dental and vision savings
More informationDental & Vision. For World Travelers of America Members. Marketed by:
Dental & Vision For World Travelers of America Members Marketed by: MAX Choice Plans Two affordable plans with benefits that increase over time What are MAX Choice Plans? Our MAX Choice plans offer individuals
More informationfor benefit recipients of the Ohio Public Employees Retirement System
2018 Vision and Dental Plan Guide for benefit recipients of the Ohio Public Employees Retirement System Eligibility and Enrollment Retirees receiving a monthly age and service or disability benefit may
More informationQuality Business Solutions Effective Date 04/01/2006 PLAN HIGHLIGHT LOW PLAN 1
PLAN HIGHLIGHT LOW PLAN 1 Combined Low Plan 1 FUSION FUSION combines dental and eye care in one benefit package. Insured employees can decide each year the health care services, which are their highest
More informationAffordable dental plan options for Blue Shield members
Affordable dental plan options for Blue Shield members January 1 December 31, 2018 Blue Shield offers two optional supplemental dental plans to Blue Shield 65 Plus SM (HMO), Blue Shield 65 Plus Choice
More informationDental & Vision. For World Travelers of America Members. Marketed by:
Dental & Vision For World Travelers of America Members Marketed by: MAX Choice Plans Two affordable plans with benefits that increase over time What are MAX Choice Plans? Our MAX Choice plans offer individuals
More informationVoluntary Dental PPO (Indemnity Plan)
Voluntary Dental PPO (Indemnity Plan) Good news about your dental benefits Your Dental Plan As a valued employee of Cypress-Fairbanks ISD, you have the opportunity to enroll in a payroll-deduction dental
More informationDental and Vision for Everyone
Dental and Vision for Everyone Dental and Vision Coverage in One Program* For Benefits Association, Inc. members including Individuals, Small Employers**, and Senior Citizens Dental Underwritten by: Delta
More informationDental and vision coverage for your total health
Dental and vision coverage for your total health The mouth and eyes are important parts of your body, and your health. Regular dental and vision checkups can help nd early warning signs of disease. So
More informationAnthem Extras Packages for Seniors
Anthem Extras Packages for Seniors Talking Points and Frequently Asked Questions FOR OHIO Background Anthem is proud to announce the availability Anthem Extras Packages for Seniors, providing coverage
More informationWESTERN MICHIGAN UNIVERSITY Group# /0048 Dental Coverage Effective Date: On or after January 2018 Benefits-at-a-glance
WESTERN MICHIGAN UNIVERSITY Group# 007005281/0048 Dental Effective Date: On or after January 2018 -at-a-glance This is intended as an easy-to-read summary and provides only a general overview of your benefits.
More informationAnthem Extras Packages
Anthem Extras Packages Dental, Vision and more California Benefits that complement your Medicare Supplement plan Packaged benefits better together Healthy teeth and eyes help contribute to your overall
More informationCalendar Year Deductible Annual Benefit Maximum. ADA Code Covered Services Member pays. n/a Office visit $5 per visit
Blue Shield of California Dental HMO Plan Dental HMO Basic Benefit summary Effective January 1, 2018 THIS MATRIX IS INTENDED TO BE USED TO HELP YOU COMPARE COVERAGE BENEFITS AND IS A SUMMARY ONLY. THE
More informationRe: Health and Dental Insurance
Five Colleges, Inc. ~ Memorandum To: All Benefited s From: Barbara Lucey Date: November, 2017 Re: Health and Dental Insurance We are staying with Harvard Pilgrim as our health insurance carrier this year.
More informationFreedom to Choose any Dentist, Including Specialists PPO Options Available 1 Fast and Accurate Claims Service No Referrals Required
Voluntary Dental PPO Good news about dental benefits for employees of Richardson Independent School District Your Dental Plan As a valued employee of Richardson Independent School District, you have the
More information23XX2293 R3/08 Blue Cross and Blue Shield of Louisiana incorporated as Louisiana Health Service & Indemnity Company
www.bcbsla.com 23XX2293 R3/08 Blue Cross and Blue Shield of Louisiana incorporated as Louisiana Health Service & Indemnity Company 1 Blue Cross and Blue Shield of Louisiana and HMO Louisiana, Inc. are
More informationDental Blue Program 2. Summary of Benefits. Amherst College
Dental Blue Program 2 Summary of Benefits Amherst College Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association Dental Blue Program 2 Preventive
More informationin partnership with Superior Dental Solutions Two Affordable Plan Options with Benefits that Increase Over Time!
in partnership with Two Affordable Plan Options with Benefits that Increase Over Time! What are Our dental plans offer individuals affordable options with benefits that increase over time to ensure you
More informationFive Colleges, Inc. ~ Memorandum
Five Colleges, Inc. ~ Memorandum To: All Benefited s From: Barbara Lucey Date: October, 2017 Re: Health and Dental Insurance Health Plan Good news, we are staying with Harvard Pilgrim this year for both
More informationTwo Affordable Plan Options with Benefits that Increase Over Time!
in partnership with Superior Dental Solutions Superior Dental Solutions Two Affordable Plan Options with Benefits that Increase Over Time! Superior Dental Solutions What are Superior Dental Solutions Our
More informationAdult Dental and Vision Coverage
Adult Dental and Vision Coverage HMO and HSP Off-Marketplace Health Plans Karen Boyd We are your Health Net. TM Optional Adult Dental and Vision coverage (ages 19 and older) with a Health Net HMO or HSP
More informationAnthem Blue Dental PPO Voluntary Option 2V Summary of Benefits
Anthem Blue Dental PPO Voluntary Option 2V Summary of Benefits Annual Benefit Limit: $1500 Annual Member Deductible: $50 PPO Dentist $50 Non-PPO Dentist Family Coverage Deductible Limit 3 times Annual
More informationDental Plans. for Individuals, Families & Self Employed
Dental Plans for Individuals, Families & Self Employed Texas Help Me Choose A Plan When can I begin receiving dental care? Discount Plan - can begin receiving benefits and dental care the day they enroll.
More informationEligibility and Enrollment
Eligibility and Enrollment Retirees receiving a monthly age and service or disability benefit may only enroll Legal spouse Must have a valid marriage certificate. Child(ren) This must be a participant
More informationCalendar Year Deductible Annual Benefit Maximum. ADA Code Covered Services Member pays
An independent member of the Blue Shield Association A50861-SG (1/19) Dental HMO Plan Dental HMO Standard Benefit summary Effective January 1, 2019 THIS MATRIX IS INTENDED TO BE USED TO HELP YOU COMPARE
More informationBUSINESS DENTAL OPTIONS. My employees want dental options.
BUSINESS DENTAL OPTIONS My employees want dental options. These are our options. MyBlueDental SM PLAN FEATURES MyBlueDental offers your employees more complete dental benefits and two choices for coverage
More informationDental Blue Program 2
SUMMARY OF BENEFITS Dental Blue Program 2 (with Orthodontics) Medium Option Massachusetts Bankers Association Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue
More informationGroup Plan Summary FASNY
Group Plan Summary FASNY Prepared by Dental Access Plan powered by Aetna Dental Access Take advantage of savings offered by the Dental Access Plan powered by Aetna Dental Access, an industry leader in
More informationBASS PRO, INC. / CABELA S
PPO BASE PLAN - Features BASS PRO, INC. / CABELA S BASE PLAN 2019 PPO Dentist Based on PPO reduced maximum plan allowance Premier Dentist Based on Premiermaximum plan allowance Non-Participating Dentist
More information2018 MPI /17 AG
2018 MPI 6532 8/17 AG affordable DENTAL AND VISION PLANS PEDIATRIC For children under the age of 19, this plan meets the Affordable Care Act (ACA) guidelines for preventive and restorative dental care.
More informationPROOF. Group Dental Plan For the State of Florida Employees and Their Families, 2018 People First Plan Codes 4021, 4022 and 4023
Group Dental Plan For the State of Florida Employees and Their Families, 2018 People First Plan Codes 4021, 4022 and 4023 Dental benefits are our specialty, and we work hard to make a plan that works for
More informationUsing Dental/Hearing/Vision Benefits as A Door Opener
Using Dental/Hearing/Vision Benefits as A Door Opener Marketing? Do your marketing efforts have you running up against these? Why? Folks can be hard to reach if what you are offering is not of immediate
More informationDental Indemnity PPO. Good news about dental benefits for retirees of ARIZONA STATE RETIREMENT SYSTEM
Dental Indemnity PPO Good news about dental benefits for retirees of ARIZONA STATE RETIREMENT SYSTEM Dental Plan Choice Our company understands that today s retirees demand choice. That s why we offer
More informationWhy do you need a dental plan?
Prepared for Comal County Guardian Group Plan Number 00406388 Why do you need a dental plan? 1 SAVE MONEY The average family spends $1353 each year on dental services, and twice that if children need braces.
More informationAmeritas is Your Dental Provider Beginning January 1, Dental benefits are our specialty and we believe we do them better than anyone else.
Ameritas is Your Dental Provider Beginning January 1, 2019 Dental benefits are our specialty and we believe we do them better than anyone else. We re Proud to Protect Your Smile Dental care is just as
More informationOregon Association of Realtors Dental Highlight Sheet
Plan 1: Dental Plan Summary Effective Date: 1/1/2019 Plan Benefit Type 1 100% Type 2 80% Type 3 50% Deductible $50/Calendar Year Type 2 & 3 Waived Type 1 $150/family Maximum (per person) $1,000 per calendar
More informationDental and vision coverage for your total health
Dental and vision coverage for your total health The mouth and eyes are important parts of your body, and your health. Regular dental and vision checkups can help nd early warning signs of disease. So
More informationHealthy. Every day. Monday: Dad tries out new workout routine at SNAP Fitness. Wednesday: Mom stops by Jenny Craig after work
Blue Cross and Blue Shield of Louisiana incorporated as Louisiana Health Service & Indemnity Company Monday: Dad tries out new workout routine at SNAP Fitness Wednesday: Mom stops by Jenny Craig after
More informationOffering State of Florida employees benefit options
Offering State of Florida employees... 2014 benefit options NO CHANGE TO YOUR PREMIUMS FOR 2014! Two dental plans to choose from Look at these features! Indemnity with PPO Insured Plan/ Freedom Advance
More informationfor benefit recipients of the Ohio Public Employees Retirement System
2019 Vision and Dental Plan Guide for benefit recipients of the Ohio Public Employees Retirement System Eligibility and Enrollment Anyone receiving a pension benefit qualifies for OPERS vision and dental
More informationOffering State of Florida employees...
Offering State of Florida employees... 2016 benefit options Two dental plans to choose from Look at these features! Indemnity with PPO Insured Plan/ Freedom Advance (People First Plan Code: 4074) Freedom
More informationCalifornia Small Group Dental Plan Portfolio Overview Simplified options! Streamlined dental plans! Easier to understand!
California Small Group Dental Plan Portfolio Overview Simplified options! Streamlined dental plans! Easier to understand! BCABR4184ABC Rev. 11/10 Dental plans and benefits you and your clients can smile
More informationHealthy Michigan Dental Plan Handbook
Healthy Michigan Dental Plan Handbook Contents 1. Welcome 2. Definitions 3. How to Use Healthy Michigan Plan 4. What Healthy Michigan Plan Covers 5. Questions and Answers 6. Grievances and Appeals 7. General
More informationKaiser Permanente and Delta Dental
Kaiser Permanente and Delta Dental Dental Program for Kaiser Permanente FEHBP Enrollees You must be a Kaiser Permanente FEHBP enrollee to participate in the dental plan. Kaiser Permanente and Delta Dental
More informationGroup Dental Insurance
Group Dental Insurance For Your Employees and Their Families Marketed By: www.siho.org Underwriting By: Ameritas Life Insurance Corp. 5900 O Street Lincoln NE 68510 S12020 Rev. 1116 Insurance Overview
More informationYou get added value with membership
You get added value with membership Aetna Dental Discount programs Dedicated service Quality plans and more 00.02.335.1 (8/07) Special products and services As an Aetna Dental member, you get added value
More informationBenefit Enhancements January 1, Vision. Hearing Aid. Dental
Benefit Enhancements January 1, 2017 Vision Hearing Aid Dental Benefit Enhancements 2017 Single In-network Providers, offering Quality Service at Great Value High-quality Dental, Vision and Hearing aid
More informationIndividual Select Preferred Dental
Individual Select Preferred Dental District of Columbia Change to Individual Select Preferred District of Columbia Applicants Beginning on October 1, 2011, all participating dentists, dental specialists,
More informationDENTAL HMO EMPLOYER SPONSORED or VOLUNTARY
DENTAL HMO EMPLOYER SPONSORED or VOLUNTARY DeltaCare USA Plan Type HMO Plan Name Silver Gold Exam & Diagnostics Office Exam Initial Oral Exam Periodic Oral Exam Teeth Cleaning Bite-Wing X-Ray Oral Surgery
More information2009 Summary of Covered Dental Services
2009 Summary of Covered Dental Services 2009 Summary of Covered Dental Services This summary shows the coverage details for the dental options offered by Xerox. It is not an all-inclusive summary of plan
More informationA Dental Benefits Program For Individuals and Families Group #2525. HDS. A plan that puts a smile on your face.
A Dental Benefits Program For Individuals and Families Group #2525 HDS. A plan that puts a smile on your face. Your Dental Benefits The health of your teeth and gums directly affects your overall health.
More informationAnthem Extras Packages for Seniors
Anthem Extras s for Seniors Talking Points and Frequently Asked Questions FOR CALIFORNIA Background Anthem is proud to announce the availability of Anthem Extras s for Seniors, providing coverage for dental,
More informationAn Overview of Your. Dental Benefits. Educators Health Alliance
An Overview of Your Dental Benefits Educators Health Alliance 2 \ DENTAL BENEFITS OVERVIEW \ 5 A Dental Plan Exclusively for Educators Health Alliance Members Something to Smile About... The EHA makes
More informationBlue Shield 65 Plus Choice Plan (HMO) benefit overview
Medicare plans that meet your needs. From a company that shares your values. Choice Plan Los Angeles (partial)/orange counties Blue Shield 65 Plus Choice Plan (HMO) benefit overview Medicare Advantage
More informationDeductible 3 Individual $50 $50. Annual Maximum Benefit: Per Individual $2,000 $2,000
Dental Plan Design for: Ector County Independent School District Original Plan Effective Date: January 1, 2018 Network: PDP Plus The Preferred Dentist Program was designed to help you get the dental care
More informationSave money on your dental & vision care!
Save money on your dental & vision care! Your dental and vision health is important, but can often be expensive. With the Compass Rose Discount Dental and Vision Plan, provided FREE to Compass Rose Health
More informationTotal Care Bulletin Welcome to the Magellan Complete Care Florida newsletter.
WINTER 2016 Total Care Bulletin Welcome to the Magellan Complete Care Florida newsletter. This newsletter is from your health plan, Magellan Complete Care. It has important information about getting and
More informationEUTF and HSTA VB Retirees Group Number 2601 Dental Plan Benefits
EUTF and HSTA VB Retirees Group Number 2601 Dental Plan Benefits A lifetime of healthy smiles for Hawai i families This brochure includes a brief description of your HDS dental benefits. All benefits are
More informationDental POS Benefit Summary
Dental POS Benefit Summary PFG HC Dental 13 Predetermination of Benefits: Before treatment begins for inlays, onlays, single crowns, prosthetics, periodontics and oral surgery, you may file a dental treatment
More informationDental Program. Insurance meets assurance. Mail Handlers Local OPEN ENROLLMENT A HEALTH PLAN TO BE SURE ABOUT DENTAL PLAN 3 EXTRA SUPPORT 9
2019 OPEN ENROLLMENT Insurance meets assurance A HEALTH PLAN TO BE SURE ABOUT DENTAL PLAN 3 EXTRA SUPPORT 9 Minnesota North Dakota UNION Mail Handlers Local 323 Dental Program For every smile Simple things
More informationBrevard Public Schools
Brevard Public Schools Your Delta Dental Benefits Plan Delta Dental PPO High & Low Option Plan Highlights Diagnostic & Preventive Maximum Waiver Benefit Missing Teeth Covered Composite Fillings Covered
More informationYour Delta Dental Program
Good oral health starts with knowledge. Smart plans for smart mouths. Your Delta Dental Program With your dental benefit program, you are free to go to any licensed dentist. However, you will save the
More informationAdvantage Plus Get dental, hearing aid, and extra eyewear benefits
en Advantage Plus Get dental, hearing aid, and extra eyewear benefits Kaiser Permanente Senior Advantage (HMO) Northwest Enroll now for 2018 H9003_ADMEM0818 accepted All plans offered and underwritten
More informationYour Dental Benefits The Local Choice. Retiree Health Benefits Program for Medicare-Eligible Retirees
Your Dental Benefits The Local Choice Retiree Health Benefits Program for Medicare-Eligible Retirees Welcome to Delta Dental of Virginia In addition to the largest network of dentists in the nation* and
More information2014 Rates. About Delta Dental networks BENEFITS OVERVIEW. Employee Only: $ Employee & Spouse: $ Employee & Child(ren): $83.
BENEFITS OVERVIEW Benefit Summary for: Denny s, Inc. Effective Date: January 1, 2014 Plan Option: HIGH PLAN Delta Dental PPO Dentacare M Delta Dental PPO & Premier Non- Participating Providers Part-Time
More informationEmployee Plan Information
Dental and Vision Premier Advantage FLEXIBLE DENTAL PLANS to meet your changing needs Employee Plan Information An option that allows you to move between the dental hmo and ppo plans as your needs change.
More informationDENTAL HMO EMPLOYER SPONSORED or VOLUNTARY
DENTAL HMO EMPLOYER SPONSORED or VOLUNTARY DeltaCare USA Plan Type HMO Plan Name Silver Gold Exam & Diagnostics Office Exam Initial Oral Exam Periodic Oral Exam Teeth Cleaning Bite-Wing X-Ray Oral Surgery
More information