0000004402 00000 n Benefits at-a-glance: EmblemHealth FEDVIP Dental Program. 0000014170 00000 n ... Federal law. GEHA offers “High Option” and “Standard Option” plans that are now better than they ever were before…and that’s really saying something! 0000012573 00000 n hŞb```b``�b`e`0acàc@ > (Ç †©'şÁ%X´LÔí2. All benefits are subject to the definitions, limitations and exclusions set forth in the 2021 Plan Brochure 409 KB. Medicaid, HARP, and CHPlus (State-Sponsored Programs), 1199SEIU Preferred Premier and Preferred Plus, What you need to know about Coronavirus (COVID-19), New Jersey: Bergen, Essex, Hudson, Middlesex, Monmouth, Morris, Passaic, Somerset, Sussex and Union, Connecticut: Fairfield, Litchfield and New Haven. 0000013360 00000 n At BENEFEDS.com, you can sign up for the EmblemHealth FEDVIP Dental Program. 0000006723 00000 n Please refer to the Dental Rating Chart to determine your specific region. 2020 Federal Employees Dental and Vision Insurance Program (FEDVIP) Dental Premium Rate Charts Please note: Rating areas for each carrier are not the same for all plans. Our plan includes 100% in-network dental coverage for preventive dental services and complex procedures. The High Plan option offers greater coverage, including adult orthodontics, and an increased per person in-network maximum of $30,000. You might be covered for orthodontic services under your Delta Dental plan. Locate a network dentist for your Delta Dental plan in FEDVIP and save on your out-of-pocket costs. 0000010233 00000 n Pursuant to Section 1557, Delta Dental's Federal Employees Dental Program Standard Option: $3,000 2021 Delta Dental Plan Highlights Welcome, Uniformed Services retirees, Federal employees and annuitants! Estimates should not be construed as financial or medical advice. 0000024138 00000 n 1327 0 obj <> endobj xref %PDF-1.4 %âãÏÓ Contact Delta Dental… Do not rely on this chart alone. You’ll be able to choose from any of our thousands of network dentists and specialists in New York, New Jersey, Pennsylvania and Connecticut without ever needing a referral or to fill out paperwork. ... Federal law. (Orthodontia benefits are effective at the time coverage begins. Benefit plans designed for federal employees and retirees, military retirees and your family. Delta Dental Individual & Family – Low Plan WELCOME Delta Dental is pleased to provide important dental Benefits that include the pediatric oral essential health benefit, to all persons who need coverage for their families. Your cost-sharing responsibilities are kept low, while you continue to get 100 percent dental coverage for in-network preventive dental services and complex procedures. Find forms. Should you choose to receive care from out-of-network dentists, just submit a claim to us. To find a dentist in your plan’s network, go to our Find a Doctor tool. 0000019046 00000 n Plan Year: Charlotte Lewis 9/27/2019 7:23:49 PM 2020 Federal Employees Dental and Vision Insurance Program (FEDVIP) Dental Premium Rate Charts Plan - Option Rating Region Please note: Rating areas for each carrier are not the same for all plans. Enrollment: 1-866-640-3856, (TDD: 711) from 8 a.m. to 8 p.m., seven days a week (excluding major holidays). 0000001559 00000 n LEARN MORE. File or view claims. 0000023824 00000 n © 2020 EmblemHealth. We’ll send you a check for the amount we cover. Our mission is to improve lives by promoting optimal oral health. It now claims to be the nation’s leading benefits provider in the United States with over 150,000 dentists participating in its large national network and many plans also providing out-of-network dental coverage. The EmblemHealth FEDVIP Dental Program is a unique program created especially for federal employees and retirees. ), High Option: $4,000 Please referto the Dental Rating Chart to determine your specific region. The Dental Care Cost Estimator provides an estimate and does not guarantee the exact fees for dental procedures, what services your dental benefits plan will cover or your out-of-pocket costs. 0000009056 00000 n Delta Dental's Federal Employees Dental Program complies with all applicable Federal civil rights laws, to include both Title VII of the Civil Rights Act of 1964 and Section 1557 of the Affordable Care Act. Please refer to your Membership Agreement, Certificate of Coverage, Benefit Summary, or other plan documents for specific information about your benefits coverage. The Dental Care Cost Estimator provides an estimate and does not guarantee the exact fees for dental procedures, what services your dental benefits plan will cover or your out-of-pocket costs. The Standard Plan option offers quality care at a low premium and per person in-network maximum of $1,500. 0000000936 00000 n 0000011658 00000 n Paid in full in-network; Deductible applies to out-of-network benefits only, Intermediate Services, and Periodontal and Endodontic Services, Covers fillings, extractions, denture/crown/bridge repair, emergency treatments, oral surgery and anesthesia/IV sedation; and specialist consultations, Covers root canals, crowns, gingivectomy periodontal surgery, fixed bridgework and dentures, High Option: $4,500 To find out, review your Contract, Policy or Evidence of Coverage booklet or check with your benefits administrator. Delta Dental PPO Plus Premier™ ©Arizona Dental Insurance Service, Inc. dba Delta Dental of Arizona. It’s easy to receive care when you have our FEDVIP Dental plan. All benefits are subject to the definitions, Your orthodontic coverage and options may vary based on your plan type: 1Your benefits may differ from the general information provided here. 0000001605 00000 n Dominion National is the brand name for the Dominion group of companies, which includes Dominion Dental Services, Inc., a licensed issuer of dental plans, and Dominion Dental Services USA, Inc., a licensed administrator of dental benefits. If a dentist who is NOT on Just answer a few quick questions to see how our High Option and Standard Option plans would work for you. Create new account. 0000003007 00000 n 0000006110 00000 n Find a dentist. 1327 32 The company also provides the best discounts, averaging 20.3% on all claims. 0000003614 00000 n Please referto the Dental Rating Chart to determine your specific region. Customer Service: call the number on the back of your member ID card, from 8 a.m. to 8 p.m., seven days a week (excluding major holidays). Delta Dental Premier dentists agree to abide by Delta Dental’s determination of fees. You must visit a dentist from the current list of DeltaCare USA network dentists. Many PPO plans also come with access to the Delta Dental Premier® network. Delta Dental is the nation's leading dental insurance company, providing access to over 145,000 dentists at more than 292,000 office locations. This free service ensures that you know up front how much, if anything, the dental plan will pay and how much you will be responsible for. Delta Dental’s PPO network is one of the nation’s largest, with more than 112,000 dentists participating in over 278,000 locations nationwide. Your coverage will continue automatically. Delta Dental Individual & Family – High Plan WELCOME Delta Dental is pleased to provide important dental Benefits that include the pediatric oral essential health benefit, to all persons who need coverage for their families. Estimates should not be construed as financial or medical advice. As one of the FEDVIP dental and vision carriers, learn more about one of the Nation's largest networks of dental … Plus, it’s easy to receive the dental care you need because you don’t need any referrals with this plan. At EmblemHealth, we believe your dental health is key to your overall health. Two exams and two cleanings per covered person are payable in a calendar year. maximum allowance; Deductible applies to out-of-network benefits only, Applies to intermediate and major services received out-of-network only, In-network: $0 Individual/$0 Family; Out-of-network: $50 Individual/$150 Family, Annual maximum per covered member (not including orthodontia), Lifetime orthodontia maximum per covered member. These dentists have agreed to contracted fees with Delta Dental, so for covered services, you pay no more than your copay and deductible. With our robust network of quality doctors, you can get care from many of the region’s leading doctors, clinicians and facilities, including hospitals and urgent care centers. The amount paid is determined on whether the dentist is a participating or a non-participating dentist. Blue Cross Blue Shield FEP Dental SM. For additional coverage beyond our health plan benefits, we offer supplemental dental coverage for federal employees and … 0000004174 00000 n 6 This not only gives you a great selection of qualified dentists to choose from, but increases the likelihood that your dentist already participates in the network. If you have any concerns about your health, please contact your health care provider's office. All Benefits are paid according to the terms, conditions, and provisions of … Or, you can call BENEFEDS at 877-888-3337 for assistance. All Benefits are paid according to the terms, conditions, and provisions of … 0000004494 00000 n 0000002627 00000 n We’re committed to creating healthier futures for our members and our community. If you have a Delta Dental PPO TM1 or Delta Dental Premier ®1 plan (our fee-for-service, open network plans), you can visit any licensed dentist, but you’ll usually save the most when you visit a dentist in your plan’s network. 0000011134 00000 n All Rights Reserved. 0000004289 00000 n Before making a final decision, please read the Plan’s Federal brochure (RI 73-321). 0000022468 00000 n 0000007711 00000 n Covers services meant to maintain good dental health, including exams, X-rays, cleanings and fluoride treatments. The Dental Care Cost Estimator provides an estimate and does not guarantee the exact fees for dental procedures, what services your dental benefits plan will cover or your out-of-pocket costs. Standard Option: $3,000. Delta Dental Premier® Delta Dental Premier is our original fee-for-service plan that offers the largest network of dentists. Delta Dental PPO TM and Delta Dental Premier ® enrollees: Before you begin implant treatment, ask your dentist to obtain a pre-treatment estimate. AdvantageCare Physicians are the newest addition to the EmblemHealth family and are now one of the largest primary and specialty care practices in New York City. Delta Dental: Best Overall. Make sure to include the EmblemHealth FEDVIP Dental Program enrollment codes as shown on the Enrollment Codes and Rates section of this page. That’s why we offer a great dental plan through the Federal Employees Dental and Vision Insurance Program (FEDVIP). Any information provided on this Website is for informational purposes only. The program is available only to eligible federal employees who live or work in New York, New Jersey, Pennsylvania, and Connecticut, in the following counties: As a FEDVIP member, you can choose from any of our thousands of network dentists. 0000008942 00000 n You can use the handy map to locate a dentist’s office when you click on his or her name in our directory. In FEDVIP, Delta Dental offers a choice between two great plans to meet your needs. Find a dentist Using an in-network provider can save you money. 0000001171 00000 n EmblemHealth FEDVIP Dental Program is a unique program that was created especially for federal employees and retirees. Delta Dental is one of the most popular dental insurance providers in … Estimates should not be construed as financial or medical advice. News. You can also call BENEFEDS at 1-877-888-3337 for assistance. Dental 2021 Federal Employees Dental and Vision Insurance Program (FEDVIP) Dental Premium Rate Charts Plan - Option Rating Region Please note: Rating areas for each carrier are not the same for all plans. Your network dentist will submit a claim after your visit and won’t bill you more than the approved amount. Please see your plan booklet or Policy for a complete description of plan benefits, limitations, and exclusions. Check my Exchange status. For easy access to information about your dental benefits, claim status, benefits eligibility and more, simply visit emblemhealth.com and register for your personal account. With 37 locations throughout New York City and Long Island, you can find a convenient location near home or work. • • Adult orthodontic coverage in the High Plan • 30,000 in-network maximum in the High Plan • Large network of dentists nationwide • 100% coverage on in-network cleanings, x-rays, fuoride treatments and exams New! 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