Bookmark & ShareHow the Dental Plans Work
The PEBB Program offers three dental plans; two managed-care plans and one preferred provider plan.
| DeltaCare | Under this managed-care plan you select a primary care dentist from the DeltaCare network. You must receive care from your selected dentist. WDS administers several dental plans, each with its own provider network, so you must confirm that your dentist is in the DeltaCare network (Group 3100) that serves PEBB members. This is important, as you could be responsible for costs if you receive care from a provider who is not in the DeltaCare network for PEBB members. You can search for providers on DeltaCare's website or verify a dentist's participation by calling DeltaCare at 1-800-650-1583. |
| Uniform Dental Plan (UDP) | This dental plan provides enrollees with the freedom to choose any dentist, but subscribers receive a higher level of coverage when they receive treatment from those dentists who participate in the WDS Delta Dental PPO plan (Group 3000). If you select a dentist who is not a WDS participating dentist, you are responsible for having your dentist complete and sign a claim form. You can verify that your dentist participates in the Delta Dental PPO network by using the search tool online or by calling UDP at 1-800-537-3406. Note: UDP does not issue ID cards. |
| Willamette Dental Group Plan | TThis managed-care plan requires that you receive care from dentists or specialists in the the plan’s network. Willamette Dental Group Plan may not have providers in all areas. You can search for providers on the plan's website or by calling the plan at 1-855-433-6825. Because dentist and clinic participation with the dental plans can change, please contact the dental plans to verify dentists and clinic locations. |
Is a Managed-Care Dental Plan Right for You?
The table below briefly compares the benefits and costs of the UDP and the managed-care dental plans. Before enrolling in a managed-care dental plan, it is important to consider the following:
- Is the dentist I have chosen accepting new patients? (Remember to identify yourself as a PEBB member.)
- Am I willing to travel for services if I select a dentist in another service area?
- Do I understand that all dental care is managed through my primary care dentist or network provider, and I cannot self-refer for specialty care?
If you are receiving continuous dental treatment (such as orthodontia) and are considering changing plans, contact the plans directly to find out if their plan will cover your continuous dental treatment.
Dental Benefits Comparison
| Uniform Dental Plan (preferred provider organization) |
DeltaCare Willamette Dental Group Plan (managed-care dental plans) |
|
| You pay | You pay | |
| Annual deductible | $50/person, $150/family | $0 |
| Annual maximum | Amounts over $1,750; orthodontia, nonsurgical TMJ, and orthognathic surgery have specific coverage maximums | No general plan maximum; nonsurgical TMJ and orthognathic surgery have specific coverage maximums |
| Benefits | ||
| Dentures | 50% PPO and out of state; 60% non-PPO |
$140 copay for complete upper or lower |
| Endodontics (root canals) | 20% PPO and out of state; 30% non-PPO |
$100 to $150 |
| Nonsurgical TMJ | 30% of costs under $500 for PPO, out of state or non-PPO; then any amount over $500 in member's lifetime | DeltaCare: 30% of costs up to $1,000/year; then any amount over $5,000 in member's lifetime Willamette Dental Group Plan: Any amount over $1,000/year and $5,000 in member's lifetime |
| Oral surgery | 20% PPO and out of state; 30% non-PPO |
$10 to $50 to extract erupted teeth |
| Orthodontia | 50% of costs under $1,750 for PPO, out of state, or non-PPO, then any amounts over $1,750 in member's lifetime | Up to $1,500 per case |
| Orthognathic surgery | 30% of costs under $5,000 for PPO, out of state, or non-PPO; then any amount over $5,000 in member's lifetime | 30% of costs under $5,000; then any amount over $5,000 in member's lifetime |
| Periodontic services | 20% PPO and out of state; 30% non-PPO |
$15 to $100 |
| Preventive/diagnostic | $0 PPO; 10% out of state; 20% non-PPO |
$0 |
| Restorative crowns | 50% PPO and out of state; 60% non-PPO | $100 to $175 |
| Restorative fillings | 20% PPO and out of state; 30% non-PPO |
$10 to $50 |
