Nemours provides Dental benefits through Delta Dental. There are three levels of dental coverage: Red, Blue and White. Contributions are taken on a pre-tax basis. Preventive services on the dental plans do not count toward your annual maximum paid by Delta Dental.
Passive PPO Network
A passive PPO allows you to choose any dentist. Although the reimbursement percentages are the same for in- or out-of-network coverage, you will save on out-of-pocket expenses by receiving services from an in-network dentist as out-of-network providers can balance bill. The Nemours plan uses both the Delta Premier and PPO networks.
You can go online to find an in-network provider in your area; use the contact information located in the Contacts section. Definitions of “Reasonable & Customary” and “Maximum Allowable Charge” are available in the Key Health Coverage Definitions section of this online guide. Please note that changes in network status can occur at any time. Check with your provider prior to your next appointment.
ID cards and a welcome letter that lists all covered dependents will be mailed to your home. Each enrolled associate will receive two ID cards. Dependent ID cards will not be provided. View the latest summary chart for Dental plans.
The following procedures have limitations on the frequency with which the procedures can be performed, as follows:
|Full Mouth X-rays||Preventive – 1 per 60 Months|
|Bitewing X-rays||Preventive – 1 per calendar year for Adults / 1 per 6 months for Children|
|Fluoride||Preventive – 1 per calendar year, to age 19|
|Sealants||Preventive – 1 sealant per permanent 1st and 2nd non-restored molar in 60 months, to age 19|
|Replacement of crowns, inlays and onlays*||Major Restorative – 1 in 5 years *Also includes partial and complete dentures; post and cores, veneers and stainless steel crowns, implants, bridges|