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 Network Status of Odessa Dentists: • Dr. Jerry Haney - Delta Dental PPO Network • Dr. Scott Heriford - Delta Dental 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
Delta Dental PPO Network Dentist Delta Dental Premier Network Dentist Non-Network Dentist Deepest Discounts No balance billing Balance billing is possible Diagnostic and Preventive Services 100% 80% Basic Restorative Services 80% 80% Major Restorative Services 50% 50% Child Orthodontic Services (to age 19) 50% 50% Base Plan Co-Insurance (Plan Pays) Calendar Year Deductible $50 person / $150 family limit Applies to: B & C Services Calendar Year Benefit Maximum Separate Lifetime Orthodontic Maximum Dependent Age Limit $1, 000 person $1, 000 per eligible dependent child 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.
Delta Dental PPO Network Dentist Delta Dental Premier Network Dentist Non-Network Dentist Deepest Discounts No balance billing Balance billing is possible Diagnostic and Preventive Services 100% Basic Restorative Services 90% 80% Major Restorative Services 60% 50% Child Orthodontic Services (to age 19) 50% 50% Buy-Up Plan Co-Insurance (Plan Pays) Calendar Year Deductible $50 person / $150 family limit Applies to: B & C Services Calendar Year Benefit Maximum Separate Lifetime Orthodontic Maximum Dependent Age Limit $1, 500 person $1, 000 per eligible dependent child 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 Questions? 1 -800 -335 -8266 • Live reps from 7 am to 5 pm Monday through Friday • Benefit 24 VRU (Virtual Response Unit) – Faxback – summary of benefits service@ddpmo. org • Email your questions www. deltadentalmo. com • Self-serve website
Technology www. deltadentalmo. com 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
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