Dental wellness is an important component in your overall health. The city offers two great dental plans.
- Dental Health Maintenance Organization (DHMO) with a network of dentists
- Dental Preferred Provider Organization plan (DPPO), a traditional plan that lets you receive a comprehensive range of dental services from the provider of your choice anywhere in the United States
Visit a network DPPO dentist to maximize your savings. These dentists have agreed to reduced fees, so your share of the bill will also be lower.
Both the DHMO and the DPPO plans offer free preventive dental care twice a year and invaluable dental health services.
Current members of these plans don’t need to do anything to remain enrolled, unless you want to switch plans. New ID cards will be issued only to members who make changes.
DHMO members will be defaulted to a primary care dentist in your zip code. If you want to choose a new dentist or change your default dentist, contact Delta Dental (see back page for contacts). Make your changes by the 21st of one month and they will be effective on the 1st of the next month. Most dentists from the previous provider are in the Delta Dental network.
A DHMO is a network of dentists that offers a comprehensive range of dental services for fixed copayments. You choose a primary-care dentist who coordinates your care and refers you to specialists. You must live in the service area to enroll. The DHMO is provided by Delta Dental.Features of the DHMO include:
- Primary Care Dentist
- Referrals for dental specialists
- Fixed copayments
- Must live in service area
- No maximum annual limits on services
- No deductibles
- No in-network claim forms
- Preventive services - $0
A DPPO is a traditional plan that lets you receive a comprehensive range of dental services from the provider of your choice anywhere in the United States. You pay a percentage of charges for certain services and file a claim for reimbursement. The plan is provided by Delta Dental.Features of the DPPO
- Choice of provider
- No Primary Care Dentist
- In-network dentist option helps reduce out-of-pocket costs
- $50 individual / $150 family annual deductible
- Annual benefit maximum of $2,000 per calendar year
- $0 deductible for preventive services
- Plan pays 100% of preventive services up to usual and customary limits
If you are enrolled in the dental-indemnity plan, you can reduce your out-of-pocket costs by using a preferred dentist. If you receive care from a preferred dentist or network of dental providers, you will receive a discount on your services and have more money in your pocket.
As you can see in the chart below, if you use a preferred dentist, you will realize a considerable savings. The more costly the dental work, such as bridges or dentures, the more savings you will realize. Also, because all fees are reduced, you will receive more services before you reach the $1,500 annual maximum benefit.
|Example savings using a preferred dentist|
|Plan||Usual cost||50% coinsurance|