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Dental Plan Effective January 1, 2016

You may receive services from any licensed dental provider. However, your choice of dentist determines the benefits you will receive and your out-of-pocket expenses. The amount paid by the Carpenters' Plan is higher when you select a dentist who participates in the Delta Dental PPOSM Network. For instance, if you use a:

  • Delta Dental PPOSM Network dentist, you will receive the highest benefits, greatest discounts, lowest annual deductible and will have the least out-of-pocket expense. In addition, there is no deductible for preventive services when you select a Delta Dental PPO provider.
  • Delta Dental Premier® Network dentist, there is a $50 deductible before preventive benefits are available, the total annual deductible is higher and the benefits you will receive will be less than if you use a Delta Dental PPO provider. This will result in more out-of-pocket expense for you.
  • Dentist who is not in a Delta Dental Network there is a $75 deductible before preventive benefits are available, the benefits you will receive will be less than if you use a Delta Dental PPO provider, there are no discounts and you will have the highest out-of-pocket expense.

 

Dental Plan Coverage Effective January 1, 2016 
Dental Benefit Coverage CategoryNetworkOut of Network
Delta Dental PPOSMDelta Dental Premier®

Deductible (Preventive) 

$0.00

$50.00

$75.00

Preventive Services

100%

75%

50%

Deductible (All other Benefits)1 

$50.00

$75.00

$75.00

Basic Services

80%

50%

25%

Major Services 

50%

40%

25%

Annual Maximum2 

$1,500.00 with/ MAXAdvantage

Orthodontic Services 

50%

Ortho Lifetime Maximum

$1,500.00

Special Provisions

MAXAdvantage3

Included

Healthy Smiles / Healthy Lives4

Extra cleanings for designated health conditions

1Deductible is cumulative – if the $50 deductible is met for preventive service from a Delta Dental Premier® dentist, the patient only has an additional $25 to reach the $75 deductible. If the first services received are basic/major, the deductible is $75.

2Annual maximum does not apply to children ages 0-19 for preventive dental services.

3MAXAdvantage does not apply routine exams and cleanings to the out of pocket maximum for these services twice per year.

4Healthy Smiles / Healthy Lives allows for increased cleanings for individuals with certain diagnoses.

Examples of Dental Procedures

Preventative Services: Routine exam, cleaning, routine x-rays

Basic Services: Extractions, amalgam fillings, root canal therapy

Major Services: Crowns, fixed bridgework and dentures

During 2019, over 68% of the Carpenters' members and their families who received dental care used a dentist in the Delta Dental PPOSM Network. By using a Delta Dental PPO provider, this helps reduce their out-of-pocket dental expenses.

Please be aware that your visit to a Delta Dental Premier provider or out-of-network provider will result in a greater out-of-pocket expense for you. To find a Delta Dental PPO provider in your area, select the Find a Provider tab on this page to search for a Delta Dental PPO provider.

Using Delta Dental will be hassle-free. If you have the Carpenters' Plan dental coverage and need an identification card or help locating a network provider, please contact Carpenters' Member Services at 314.644.4802 or toll-free at 877.232.3863 or by email at benefits@carpdc.org.