| Plan year maximum, per
member |
|
First year benefit maximum |
$750 |
Second year benefit maximum |
$1,000 |
Third year benefit maximum |
$1,250 |
| Plan year deductible, per
member |
$50 |
| Service |
Benefit |
| Preventive |
Examinations/x-rays (routine exam
& bitewing x-rays)
Prophylaxis (cleanings)
Fissure sealants
Fluoride
|
|
Premier
Network |
| 80% |
| Basic - Six Month Waiting Period |
Restorative dentistry (treatment
of tooth decay with amalgam, synthetic porcelain
and plastic materials)
Space maintainers
|
|
60% |
| Major - Twelve Month Waiting Period |
Oral Surgery (surgical extractions
& certain minor surgical procedures)
Endodontic (pulp therapy and root canal filling)
Periodontics (treatment of tissues supporting the teeth)
Crowns
Cast restorations
Dentures and bridge work (construction or repair of fixed bridges, partials and complete dentures)
|
|
50% |
Advantages:
- Freedom to choose your dentist ODS is uniquie in that we have contracts with over 1,800 licensed dentists in Oregon. As the Delta Dental Plan of Oregon, we offer access to
over 100,000 dental professionals nationwide.
- Professional Arrangements ODS has specific fee arrangements with our participating dentists to ensure that actual charges made by the dentist do not exceed his or her accepted
fees on file with ODS and our Delta Dental affiliates. We believe that the underlying unique feature inherent to all ODS programs is every participating dentist becomes a party to cost control
as well as teh quality of care. Participating dentists will update your records with your new information and will submit claims to ODS for you.
- myODS is a customized member website with current, accurate and easy to understand information about the member's plan.
Dependent Eligibility
Dependents are lawful spouse, Oregon registered domestic partners and eligible children to age 26, including children an employee is required to enroll due to a court or administrative order.
|
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