Page 16 - Fontbonne University 2022 Benefits Guide
P. 16
DENTAL
MAXAdvantage Program
Fontbonne’s dental coverage includes Delta’s Fontbonne University continues to partner with
MAXAdvantage beneit program. This beneicial feature
excludes many preventive and diagnostic service charges Delta Dental to ofer dental coverage.
(exams, cleanings, etc.) from applying to a member’s
calendar year maximum. This allows you to maintain your Delta Dental ofers two networks: a Premier and
preventive dental care routine while saving your annual
maximum for other dental services that you may need non-participating dental network and a PPO dental
throughout the year! network. You will ind the greatest discounts with
providers who are under the PPO network. Most
providers in the PPO network are also in the Premier
Healthy Smiles, Healthy Lives network because it is a larger network. Note—
Fontbonne’s dental program also includes Delta Dental’s dentists not in either network are considered non-
Healthy Smiles, Healthy Lives beneit. This program provides participating providers; this means they can balance
eligible members with additional cleanings (up to 4 per
year!) to help reduce risks associated with periodontal bill you and require you to submit a claim. When
disease and certain existing medical conditions. It also seeking treatment with a non-participating provider
covers brush biopsies for early detection of oral cancer. you may also experience higher out-of-pocket
expenses. It is always to your advantage to seek
Eligible members include those being treated for periodontal
disease, pregnancy, diabetes, and a suppressed immune treatment with an in-network provider.
system.
To ind an in-network dentist, visit
www.deltadentalmo.com, select “Find a Provider”
and then click on “Find a Dentist.”
Delta Dental of Missouri
Premier
and Non-
PPO Dentist
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
MAXAdvantage Program
Fontbonne’s dental coverage includes Delta’s Fontbonne University continues to partner with
MAXAdvantage beneit program. This beneicial feature
excludes many preventive and diagnostic service charges Delta Dental to ofer dental coverage.
(exams, cleanings, etc.) from applying to a member’s
calendar year maximum. This allows you to maintain your Delta Dental ofers two networks: a Premier and
preventive dental care routine while saving your annual
maximum for other dental services that you may need non-participating dental network and a PPO dental
throughout the year! network. You will ind the greatest discounts with
providers who are under the PPO network. Most
providers in the PPO network are also in the Premier
Healthy Smiles, Healthy Lives network because it is a larger network. Note—
Fontbonne’s dental program also includes Delta Dental’s dentists not in either network are considered non-
Healthy Smiles, Healthy Lives beneit. This program provides participating providers; this means they can balance
eligible members with additional cleanings (up to 4 per
year!) to help reduce risks associated with periodontal bill you and require you to submit a claim. When
disease and certain existing medical conditions. It also seeking treatment with a non-participating provider
covers brush biopsies for early detection of oral cancer. you may also experience higher out-of-pocket
expenses. It is always to your advantage to seek
Eligible members include those being treated for periodontal
disease, pregnancy, diabetes, and a suppressed immune treatment with an in-network provider.
system.
To ind an in-network dentist, visit
www.deltadentalmo.com, select “Find a Provider”
and then click on “Find a Dentist.”
Delta Dental of Missouri
Premier
and Non-
PPO Dentist
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
