Page 16 - Fontbonne 2021 New Hire Guide
P. 16
MAXAdvantage Program DENTAL
Fontbonne’s dental coverage includes Delta’s Fontbonne University partners with Delta Dental to
MAXAdvantage beneit program. This beneicial feature offer dental coverage.
excludes many preventive and diagnostic service
charges (exams, cleanings, etc.) from applying to a
member’s calendar year maximum. This allows you Delta Dental offers two networks: a Premier and non-
to maintain your preventive dental care routine while participating dental network and a PPO dental network.
saving your annual maximum for other dental services You will ind the greatest discounts with providers who
that you may need throughout the year!
are under the PPO network. Most providers in the
PPO network are also in the Premier network because
Healthy Smiles, Healthy Lives it is a larger network. Note—dentists not in either
Fontbonne’s dental program also includes Delta network are considered non-participating providers;
Dental’s Healthy Smiles, Healthy Lives beneit. This this means they can balance bill you and require you to
program provides eligible members with additional submit a claim. When seeking treatment with a non-
cleanings (up to 4 per year!) to help reduce risks participating provider you may also experience higher
associated with periodontal disease and certain existing
medical conditions. It also covers brush biopsies for out-of-pocket expenses. It is always to your advantage
early detection of oral cancer. to seek treatment with an in-network provider.
Eligible members include those being treated for To ind an in-network dentist, visit
periodontal disease, pregnancy, diabetes, and a
suppressed immune system. www.deltadentalmo.com, select “Find a Provider”
and then click on “Find a Dentist”.
Delta Dental of Missouri
Premier and
PPO Dentist Non-Participating
Dentist
Deductible
Individual $50 $100
Family Limit $100 $300
Applies To B & C B & C
Maximums
Calendar Year Maximum $1,500 $1,500
(A, B, and C)
Orthodontic Lifetime $1,500 $1,500
Maximum (D)
Coinsurance
Coverage A (preventive) 100% 100%
Coverage B (basic) 90% 80%
Coverage C (major) 60% 50%
Coverage D (orthodontic) 50% 50%
Dental Contributions—Monthly
Employee Only $8.25
Employee + Spouse $58.85
Employee + Child(ren) $65.30
Family $86.70
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Fontbonne’s dental coverage includes Delta’s Fontbonne University partners with Delta Dental to
MAXAdvantage beneit program. This beneicial feature offer dental coverage.
excludes many preventive and diagnostic service
charges (exams, cleanings, etc.) from applying to a
member’s calendar year maximum. This allows you Delta Dental offers two networks: a Premier and non-
to maintain your preventive dental care routine while participating dental network and a PPO dental network.
saving your annual maximum for other dental services You will ind the greatest discounts with providers who
that you may need throughout the year!
are under the PPO network. Most providers in the
PPO network are also in the Premier network because
Healthy Smiles, Healthy Lives it is a larger network. Note—dentists not in either
Fontbonne’s dental program also includes Delta network are considered non-participating providers;
Dental’s Healthy Smiles, Healthy Lives beneit. This this means they can balance bill you and require you to
program provides eligible members with additional submit a claim. When seeking treatment with a non-
cleanings (up to 4 per year!) to help reduce risks participating provider you may also experience higher
associated with periodontal disease and certain existing
medical conditions. It also covers brush biopsies for out-of-pocket expenses. It is always to your advantage
early detection of oral cancer. to seek treatment with an in-network provider.
Eligible members include those being treated for To ind an in-network dentist, visit
periodontal disease, pregnancy, diabetes, and a
suppressed immune system. www.deltadentalmo.com, select “Find a Provider”
and then click on “Find a Dentist”.
Delta Dental of Missouri
Premier and
PPO Dentist Non-Participating
Dentist
Deductible
Individual $50 $100
Family Limit $100 $300
Applies To B & C B & C
Maximums
Calendar Year Maximum $1,500 $1,500
(A, B, and C)
Orthodontic Lifetime $1,500 $1,500
Maximum (D)
Coinsurance
Coverage A (preventive) 100% 100%
Coverage B (basic) 90% 80%
Coverage C (major) 60% 50%
Coverage D (orthodontic) 50% 50%
Dental Contributions—Monthly
Employee Only $8.25
Employee + Spouse $58.85
Employee + Child(ren) $65.30
Family $86.70
16
