| 2008 Dental Plan Design Q&A |
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For 2008, your Benefit Board made changes to dental benefits. These changes fit the PEBB Vision for high quality, affordable healthcare. Here are questions and answers about the changes.
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Why did the Board change the frequency of coverage for dental cleanings?
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For some people – for example, those with advanced gum disease or diabetes or women who are pregnant – evidence indicates there may be a need for additional cleaning beyond two times per year. For children and adults with healthy teeth and gums, no research supports more than one cleaning per year. Talk with your dentist about your oral health.
Read the summary of evidence presented to the Board on dental plan changes for 2008.
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Will my benefits cover additional cleanings if my dentist thinks I need them?
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Talk to your dentist about your oral healthcare needs. Your dentist will work with your plan, and more frequent cleanings may be covered. For example, if you have braces or gum disease, you may be eligible for up to two cleanings per year. If you are diabetic, pregnant or have had gum surgery, you may be eligible for up to four cleanings per year.
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Why did the Board change the frequency of coverage for dental X-rays?
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Research shows that dental X-rays for most people are not needed every year. Radiation from X-rays accumulates over a lifetime and may increase your risk of cancer. Beginning in 2008, benefits will cover bitewings every 12 months for members younger than 15 and every 24 months for those 15 or older. You may be eligible for more frequent X-rays – for example if you have had two or more fillings in the last two years.
Read the summary of evidence presented to the Board on dental plan changes for 2008.
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Why did the Board change the Kaiser dental plan design?
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For 2008, the Board asked Kaiser Permanente to offer a plan design that is like the ODS traditional plan. This traditional plan design offers dental benefits that are in line with the latest research and that are less costly. Members will still access services through Kaiser dentists and facilities. Kaiser will also offer a traditional dental plan design for part-time employees and retirees.
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If I want to stay with the same dental plan, will I need to re-enroll or change dentists?
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No. If you don’t want to change your plan – whether it’s Kaiser, ODS or Willamette Dental – your current dental enrollment will continue through 2008, and you will be able to keep the same dentist.
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Why is the member coinsurance amount for implants higher in the Willamette Dental plan than in the other plans?
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The other plans have an annual benefit maximum, while Willamette Dental doesn’t. In the Kaiser and ODS plans in 2008, after you have used $1,750 worth of benefit, you must pay for additional services in full. The Willamette cost-share of 75 percent for implants offsets the lack of an annual benefit maximum, which helps to keep the plan affordable.
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