Page 13 - 2018 Sulzer (Chemtech Mixpac) Benefit Guide
P. 13
Sulzer
Dental Find an In-Network
Delta Dental of Texas Provider
Remember to visit in-network (Delta
Access to good oral healthcare is important to your overall health. This is Dental PPO or Delta Premier) dentists
why Sulzer offers dental insurance as a core part of your beneits package. to receive the deepest level of discount
on your services. Delta PPO dentists
In-Network have agreed to provide discounts from
Delta PPO and Delta Out-of-Network** 20% to 30%; Delta Premier from 5%
Premier to 10%. Out-of-network dentists will
Calendar Year Deductible be reimbursed at the Delta Premier
Individual $50 $50 maximum allowable charge and may
Family $150 $150 balance-bill you for the difference
Calendar Year Maximum $1,500 $1,500 between billed and allowed charges.
Coinsurance To ind a participating Delta PPO or
Preventive* 100% no deductible 100% no deductible Delta Premier dentist in your area go
Basic 80% after deductible 80% after deductible to www.deltadentalins.com.
Major 50% after deductible 50% after deductible
Orthodontia Orthodontia Services
Coinsurance 50% no deductible 50% no deductible Note
Lifetime Maximum $1,500 $1,500
Beneit Applies to Adults and children Adults and children The lifetime maximum illustrated here
is different than the calendar year
* Preventive care does not apply to the annual maximum beneit.
** Reimbursed at the Delta Premier maximum allowable charge maximum. For orthodontia services,
this limit does not reset each year,
Estimate Your Costs Online this is the most your plan will cover
for your services for the lifetime of
Delta Dental’s online Cost Estimator gives you a personalized estimate of yourself or child in this program.
how much you’ll pay for your next dentist visit. Log in to your account
at deltadentalins.com and click on Cost Estimator. Start by selecting the Examples of Services
service you need. As you explore, you can answer additional questions X Preventive—exams, cleanings,
to further customize your results. Compare your current dentist to other luoride, x-rays, sealants
providers. X Basic—illings, extractions,
periodontics, repairs, and oral
Dental Hygiene and Pregnancy surgery
Expecting a baby? There’s a lot to think about. But don’t forget about X Major—crowns, inlays, dentures,
dental implants
your teeth. Being pregnant puts you at higher risk for tooth decay, gum
disease (also known as “pregnancy gingivitis”), and oral growths called
“pregnancy tumors.” If you have moderate to severe gum disease, you
may be at higher risk for delivering a pre-term, low birth weight baby.
Dental cleanings are a great way to keep your teeth and gums healthy.
Your dental plan covers an additional cleaning during the year for
pregnant women.
13
Dental Find an In-Network
Delta Dental of Texas Provider
Remember to visit in-network (Delta
Access to good oral healthcare is important to your overall health. This is Dental PPO or Delta Premier) dentists
why Sulzer offers dental insurance as a core part of your beneits package. to receive the deepest level of discount
on your services. Delta PPO dentists
In-Network have agreed to provide discounts from
Delta PPO and Delta Out-of-Network** 20% to 30%; Delta Premier from 5%
Premier to 10%. Out-of-network dentists will
Calendar Year Deductible be reimbursed at the Delta Premier
Individual $50 $50 maximum allowable charge and may
Family $150 $150 balance-bill you for the difference
Calendar Year Maximum $1,500 $1,500 between billed and allowed charges.
Coinsurance To ind a participating Delta PPO or
Preventive* 100% no deductible 100% no deductible Delta Premier dentist in your area go
Basic 80% after deductible 80% after deductible to www.deltadentalins.com.
Major 50% after deductible 50% after deductible
Orthodontia Orthodontia Services
Coinsurance 50% no deductible 50% no deductible Note
Lifetime Maximum $1,500 $1,500
Beneit Applies to Adults and children Adults and children The lifetime maximum illustrated here
is different than the calendar year
* Preventive care does not apply to the annual maximum beneit.
** Reimbursed at the Delta Premier maximum allowable charge maximum. For orthodontia services,
this limit does not reset each year,
Estimate Your Costs Online this is the most your plan will cover
for your services for the lifetime of
Delta Dental’s online Cost Estimator gives you a personalized estimate of yourself or child in this program.
how much you’ll pay for your next dentist visit. Log in to your account
at deltadentalins.com and click on Cost Estimator. Start by selecting the Examples of Services
service you need. As you explore, you can answer additional questions X Preventive—exams, cleanings,
to further customize your results. Compare your current dentist to other luoride, x-rays, sealants
providers. X Basic—illings, extractions,
periodontics, repairs, and oral
Dental Hygiene and Pregnancy surgery
Expecting a baby? There’s a lot to think about. But don’t forget about X Major—crowns, inlays, dentures,
dental implants
your teeth. Being pregnant puts you at higher risk for tooth decay, gum
disease (also known as “pregnancy gingivitis”), and oral growths called
“pregnancy tumors.” If you have moderate to severe gum disease, you
may be at higher risk for delivering a pre-term, low birth weight baby.
Dental cleanings are a great way to keep your teeth and gums healthy.
Your dental plan covers an additional cleaning during the year for
pregnant women.
13
