The A&M Dental plan is designed to ensure that you receive good preventive care. The Texas A&M University System currently offers a choice between two dental plans. A&M Dental is a PPO plan. It includes networks of dentists which can save you money. Most exams and procedures are paid on a percentage basis up to a plan maximum. DeltaCare is an HMO plan. The plan offers fixed copayments for exams and procedures and you will choose a network dental provider. The HMO is not available in all areas and some areas have a limited number of providers.
The plan covers four types of care: Preventive (checkups, cleanings); Basic (fillings, root canals, extractions, endodontics); Major (crowns, dentures); and Orthodontics (braces). The plan has a schedule that lists your share of the cost of each dental service.
The A&M Dental PPO and the DeltaCare USA Dental HMO premiums are paid b the employee for the cost of dental coverage on a before-tax basis. The FY 16 benefit plan year are effective September 1 ,2015 thru August 31, 2016 and are subject to change each FY benefit plan year.
Effective September 1, 2015-August 31, 2016
The Delta Dental PPO Plan highlights the eligibility, deductibles, benefits and covered services. While dental health care costs are generally lower than medical health care costs, it is to your advantage to understand how to use your dental plan so that you can enjoy potentially lower out-of-pocket costs and user-friendly payment of approved claims. The cost for dental services (and your potential out-of-pocket expense) is determined by where you receive your treatment. Listed below are the different network options to choose from: Delta Dental PPO, Delta Dental Premier Dentists, and the Non-Delta Dental Dentists.
The Delta Dental HMO Plan is a pre-paid type plan compared to the PPO plan that is a fee-for service, preferred provider plan. The HMO plan has over 300 covered procedures, including tooth bleaching and posterior composites. The plan has no copayments or low copayments for most diagnostic and preventive services. Out-of-area coverage is limited to emergency care provisions. The enrollee must select a dentist from a list of network dental facilities and must visit this dentist to receive benefits. The HMO plan does not require claim forms to be completed, however specified copayments are due at time of visit. After enrollment is complete, the enrollee will receive a membership packet that includes an identification card, and an Evidence of Coverage that fully describes the benefit of the dental plan. Also included in the packet are the name, address and phone number of your contract dentist. Simply call the dental facility to make your appointment. See the “Description of Benefits and Copayments” for a list of the benefits.