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Published byScarlett Ball Modified over 9 years ago
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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
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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
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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 Services100%80% Basic Restorative Services80% Major Restorative Services 50% Child Orthodontic Services (to age 19) 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 LimitEnd 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.
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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 Services100% Basic Restorative Services90%80% Major Restorative Services60%50% Child Orthodontic Services (to age 19) 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 LimitEnd 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.
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Technology 1-800-335-8266 Live reps from 7am to 5pm Monday through Friday Benefit24 VRU (Virtual Response Unit) –Faxback – summary of benefits service@ddpmo.org Email your questions www.deltadentalmo.com Self-serve website Questions?
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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
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