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Health
& Welfare Dental
Dental - Frequently
Asked Questions
Is there a Preferred Provider (PPO) for dental services?
The Plan has no preferred providers for dental services, nor does it
maintain a referral list of dentists. You may go to the dentist of
your choice.
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Is
fluoride treatment a covered expense for adults?
Yes, all participants and dependents are allowed one fluoride
treatment per year.
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My routine cleanings and exams were only 5 months apart - will
the Plan still pay for them? Do they have to be six months apart?
Participants
and dependents are allowed two cleanings and exams within a calendar
year, they do not need to be six months apart..
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Will the Plan pay for a cosmetic treatment I need for my teeth?
No, the Plan will not pay for treatments or services which are
primarily for cosmetic purposes.
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Are fluoride toothpaste or other home health care products I need
covered under the plan?
Flouride toothpaste and other health
care products designed for use at your home are not covered expenses
under Plan.
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What dental treatments or procedures do I need to have pre-authorized?
No, pre-authorization
is not required for any dental services. However,
intravenous sedation
is
covered only when
treatment warrants the sedation. If you are unsure whether your
treatment warrants sedation, you or dentist may call for
pre-authorization.
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I need to travel to
another town to have some dental work done. Will the Plan pay
for
my travel expenses?
No, the Plan does not cover travel expenses for dental services.
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What does it mean my charges exceeded the " usual and customary"?
Usual and customary charges are the average charges
for
designated services provided in a particular area. This information
is gathered continuously by a national service. The
Administrative Office
receives an update every six months. Should your provider charge
in excess of the usual and customary, you are responsible for all of
the amount over the usual and customary.
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Is
nitrous oxide covered under the Plan?
Nitrous oxide is a covered expense only for dependent children age 12
and under. It is not covered for those over the age of 12.
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What types of sedation are covered under the dental plans?
Nitrous oxide is covered for dependent children age 12 and under.
Intravenous sedation is covered only if treatment warrants that type
of sedation. As a rule, general anesthesia is not a covered expense.
Contact the Administrative Office if you have questions regarding sedation and
anesthesia coverage.
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