Your Benefits 2018 Dental Coverage Delta Dental

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1 Your Benefits 2018 Dental Coverage Delta Dental

2 WHAT S NEW FOR 2018 NEW AND IMPROVED DENTAL PLAN Check out the great new dental program being offered through Delta Dental The Base Option PPO annual maximum has increased by 50% - from $1,000 to $1,500. There s a new DHMO plan that replaces the Copay plan - No annual maximum for dental services - Includes orthodontia for up to 24 months of active treatment - You must select a primary care dentist from the network to enroll, but you can change at any time. Search for a dentist online - See your Employee Benefits Guide for what else is new for 2018 as well as a handy checklist to use for open enrollment! 2

3 Dental Coverage Delta Dental of Arizona 3 dental plans to choose from: Base PPO Plan, Buy Up PPO Plan, and DHMO Plan Semi-annual preventive care is covered 100% No deductible Services performed by an in-network dental provider If you enroll in either the Base PPO Plan or the Buy Up PPO Plan You can visit any licensed dentist You pay the lowest out-of-pocket costs when you receive services from a Delta Dental dentist in the PPO network After you pay the deductible, the PPO plans pay a percentage of the cost for basic and major services. You pay the remaining percentage up to the plan s benefit maximum for covered services. 3

4 Delta Dental PPO Network Strength The Delta Dental network has more than 152,000 dentists nationwide, with more than 102,000 of those dentists participating in the PPO network. 2 1 Above graphic is representative of the network composition in Arizona. National network composition may differ. 2 Delta Dental Plans Association internal data, 4

5 PPO Takeover for Orthodontia and General Dental Procedures After January 1, 2018, let your orthodontist know that you now have Delta Dental of Arizona or provide them with your new Dental ID card. Your provider will then submit your treatment plan to Delta Dental of Arizona s customer service team for payment takeover. Delta Dental of Arizona will work with your provider behind the scenes to provide you continuity of coverage and determine your remaining benefit. General dental procedure claims are paid based on the initial date of treatment, so if treatment starts in December, it will be a MetLife claim. If treatment is started in January, it will be a Delta Dental of Arizona claim. Before starting treatment with a cost of $250 or more, it is recommended to have your dentist submit a predetermination. This will act as an estimate and provide you with detailed information regarding what Delta Dental will cover and what your financial obligation will be. 5

6 Dental Coverage Delta Dental of Arizona If you enroll in the DHMO Plan You must select a Delta Dental dentist in the DeltaCare USA network You can search for a network dentist at: You don t have to be enrolled in the plan to search for a dentist Dental services must be provided by a Delta Dental dentist in the DeltaCare USA network to have benefits under the plan You pay a fixed copay for covered services if those services are performed by a Delta Dental provider in the DeltaCare USA network. 6

7 Delta Dental of Arizona - DHMO Advantages of DeltaCare USA Covered procedures have predetermined dollar copays for services Out-of-pocket costs are clearly defined No deductibles, maximums or claim forms Out-of-area dental emergency coverage up to $100 per emergency Easy access to specialty care Each family member can select their own dentist Change dentist online or with a call 7

8 DHMO Network Strength The Delta Dental DHMO uses the DeltaCare USA network One of the nation s largest DHMO networks Enrollees select a DeltaCare USA dentist to provide most covered services Low turnover of network dentists, so enrollees can establish a longterm relationship with their dentist Easy referrals to a large specialty care network DeltaCare USA has over 60,000 dentists nationwide with access to dental care in all 50 states. 8

9 DHMO Orthodontia Takeover Seamless orthodontic takeover Enrollees in current orthodontic treatment keep their orthodontist Enrollees only pay remaining balance they owe orthodontist no loss/no gain Plan pays any remaining balance the prior carrier owes the orthodontist Treatment in progress even for non-deltacare USA dentists from PPO or DHMO group plan 9

10 Member Resources ONLINE SERVICES deltadentalins.com Log in or create a new account to: Check benefits and eligibility Find/change dentists Print ID cards Manage profile DELTA DENTAL MOBILE APP Download the Delta Dental Mobile App for on-the-go access to your ID card, member benefits, cost estimator, dentist search & toothbrush timer! Free for Android & ios devices in the Apple App & Google Play stores. 10

11 FIND A NETWORK DENTIST To find in-network dentists, visit You can search for dentists before you enroll in the plan 11

12 Enter your zip code Select the plan network to search if you choose the Basic or Buy Up Plans, you can use PPO or Premier dentists. DeltaCare is the DHMO network. You can also search by dentist or practice name Click Search Don t forget if you elect the DHMO Plan you must enter your Provider ID to enroll. Have it ready before you go online or call. 12