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Dental

Routine oral care is key to maintaining a healthy and active lifestyle

The ability to smile at a loved one or share dinner with friends are examples of the important ways we interact with others. Yet, these simple moments are at risk as you age and your oral health faces new obstacles.

Issues such as dry mouth, gum disease, and tooth loss can affect a person’s social life and health but should not be accepted as a natural part of aging. Routine oral care is critical as you pass the age of 65. It prevents conditions such as gum inflammation which is directly associated with lung and heart disease, and strokes.

Still, it can be tempting to cancel or postpone routine dental appointments because of an inability to pay for its services, according to the Centers for Disease Control and Prevention. Fortunately, you don’t have to choose between your health and financial livelihood. Our plans provide important, routine dental care – such as cleanings, dental exams, and X-rays – at no cost to you and from a national network of dentists.  

Our plan also has you covered when the time comes for work that is more extensive. For a minimum monthly premium, you can choose from one of two supplemental dental benefit plans – Dental Silver or Dental Gold.1

Call to speak with one of our advisors or go online today to enroll and begin enjoying benefits like this. The best way to treat disease is to take steps to prevent it from developing in the first place. 

Making the most of our dental benefits as a member

Call Member Services at 1-800-240-3851 (TTY 711) between 8 a.m. and 8 p.m. 

Visit the Dental Plan website to search by location, dentist name or practice name.2

MercyOne Health Plan Cash Back MAPD (HMO) and MercyOne Health Plan Cash Back (HMO) include Basic dental coverage. 

All other plans include a combination of Basic and Comprehensive dental coverage, which covers certain restorative and extraction services at 50% coinsurance as well as endodontics and periodontics at 70% coinsurance.

There is a $1,000 annual combined benefit maximum. 

Dental Silver is a supplemental option and offers enhanced comprehensive services in addition to the preventive and comprehensive dental services included in your health plan. The annual benefit maximum for Dental Silver is $1,500.   

Dental procedures covered with a Dental Silver plan for HMO members (last updated 10/01/2024)

Dental procedures covered with a Dental Silver plan for PPO members (last updated 10/01/2024)

Dental Gold is a supplemental option and includes everything in Dental Silver, plus coverage toward crowns, bridges, and dentures. The annual benefit maximum for Dental Gold is $2,000.

Dental procedures covered with a Dental Gold plan for HMO members (last updated 10/01/2024)

Dental procedures covered with a Dental Gold plan for PPO members (last updated 10/01/2024)

Only the Dental Gold supplemental benefit provides 50% coinsurance coverage for dentures.

You can enroll in Dental Silver or Dental Gold when you first join MercyOne Health Plan, or you can add or make changes to your optional supplemental dental plan during the Annual Enrollment Period from Oct. 15 through Dec. 7 each year.

2024 Plan Year: Dental Silver is available for $14 per month for HMO members and $13 per month PPO members. Dental Gold is available for $34 per month for both HMO and PPO members.

2025 Plan Year: Dental Silver is available for $14 per month for HMO members and $12 per month PPO members. Dental Gold is available for $34 per month for both HMO and PPO members.

Please note that the Optional Supplemental Dental premium is in addition to your monthly plan premium, if applicable, and your Medicare Part B premium. 

1 The Optional Supplemental Dental Benefit is not available on the 2024 MercyOne Health Plan Cash Back MAPD (HMO) or 2025 MercyOne Health Plan Cash Back (HMO) plan.

2 PPO plan members who elect the optional dental plan can receive care from dentists in and out of the network. For services received through non-participating providers, members may pay a higher cost share.

Benefits vary by plans. For more details, please refer to your Evidence of Coverage. 

This page was last updated 10/15/2024

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