Page 7 - Fort Health Care 2022 Benefit Guide

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DENTAL

Regular dental exams can help you and your dentist detect problems in the early stages when treatment is simpler, and
costs are lower. Keeping your teeth and gums clean and healthy will help prevent most tooth decay and periodontal
disease, and is an important part of maintaining your medical health.

We have added the UnitedHealthcare Dental PPO option to our plan. What this means for you – you can continue to go
to any provider that you choose for your dental care needs, but if you go to one of the providers in the UnitedHealthcare
Dental PPO, you could see additional savings. The UHC Dental PPO allows us access to a group of dentists that are offering
their services at a discounted rate. Additional information can be found on the next page (pg. 8).

Please note: Elections will require a 2-year enrollment into the Dental plan.

Plan Provision Plan Coverage
Annual deductible (Individual/family) $25 Single
$75 Family
Annual maximum per person $1,200
Diagnostic and preventive care: 80%
No deductible
Includes cleanings, fluoride treatments, sealants, Does not apply to Annual maximum
and x-rays
Basic services: 80% after deductible
Includes fillings, periodontics, scaling and root
Major services: Includes bridges and full and partial 80% after deductible
planning, oral surgery, crowns

dentures
Orthodontia 50% after deductible
(Children only up to age 20) $1,400 lifetime maximum
No deductible

DENTAL NETWORK

Fort HealthCare’s Dental Plan has an open network. What does that mean for you?
It gives you the flexibility to go to the provider of your choice. It also means that
some providers can charge you more.

We partner with UMR and have an added benefit to use the UnitedHealthcare
Dental PPO network. UnitedHealthcare has negotiated additional discounts that
the next page.
saves you and the plan from higher costs. Additional information can be found on

Guide to Your Benefits | May 1, 2022 – April 30, 2023