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Your Dental Benefits
To encourage good dental health, the plan pays a higher benefit for preventive and diagnostic care, and a lower benefits for restorative services. Here are brief descriptions of covered services in each category:
- Preventive and Diagnostic Care: routine exams, cleanings, X-rays, surface flouride treatment.
- Basic Restorative Services: fillings and extractions, root canal therapy, periodontal care, inlays, onlays, gold fillings, crown restoration.
- Major Restorative Services: full or partial removable dentures, fixed bridgework, repair or replacement of dentures or bridgework.
- Oral Surgery: surgical removal of impacted teeth or dental root resection.
- Orthodontia: If you have a choice of dental plans, only one includes orthodontia. Check your coverage details.
In-Network or Out-of-Network?
United Concordia, Alcoa's dental claims administrator, has an extensive network of dentists who accept negotiated or discounted rates. Your coinsurance percentage is the same whether you use an in-network or out-of-network provider. Here are some differences you need to know:
- If you use an in-network dentist, you will pay your coinsurance based on a negotiated rate. And your dentist will file your claims for you.
- If you use an out-of-network dentist, you pay any difference between the reasonable and customary (R&C) charges and the dentist's actual charge, plus your coinsurance. You also may be responsible for filing claims.
To find an in-network dentist, visit the United Concordia website at www.ucci.com (click on "Clients' Corner" then "Alcoa").
When Should I Request An Estimate?
When you or a covered dependent needs dental treatment that may cost more than $300, request a "pre-treatment estimate" (also called a predetermination of benefits) from United Concordia. This will let you and your dentist know in advance how the treatment will be covered and also point out any less expensive alternatives.
To file for predetermination, have your provider complete a standard American
Dental Association (ADA) claim form.
Is Preventive Care Free?
Yes. Your dental plan covers two routine cleanings and bitewing X-rays per year, along with surface fluoride treatment.
What about X-Rays?
Your plan covers bite-wing X-rays twice per year. However, full-mouth X-rays are covered only once every three years. If your dentist suggests a full-mouth X-ray, ask her to check her records for the date of your last one. If you are moving to a new dentist, have your full-mouth X-rays transferred.
What Happens if I Need Dental Care When Traveling?
Call 1-800-433-9906. A United Concordia customer service representative may be able to give you names of in-network providers in the area that you are visiting. As is true when you are at home, your best bet is to use an in-network dentist if possible.
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