We cover exams, cleanings, and fillings for all UPMC for You members. Avesis manages UPMC for You Dental benefits. Members can call Dental Member Services at 1-888-257-0474 to get a dentist’s name or to see what dental benefits they have.
How can I find out which dental plans have my dentist in- network ? The best way is to ask your dentist . You can also check the provider directory for each plan at www.opm.gov/healthcare-insurance/dental-vision/plan-information/.
Fixed bridgework, crowns, inlays, and onlays are covered by UPMC Dental Advantage only if initiation of treatment and preparation of teeth and placement of teeth occurs after the member is covered under the UPMC Dental Advantage plan. Otherwise, the prior dental carrier is responsible for the claim.
If you are age 21 and older and covered by Pennsylvania’s Medical Assistance program, you likely have dental coverage. This is true whether you are covered by the ACCEESS card or a HealthChoices managed care plan.
Dental benefits include: $0 copay for one oral exam, cleaning, and x-ray every six months. A $3,000 or $5,000 yearly allowance (depending on the plan offered in your area) for additional services like dentures, bridges, root canals , crowns, fillings and simple tooth extractions.
Travel with a Plan If you are traveling outside UPMC Health Plan’s service area and need nonemergency care, you can : Call Member Services at 1-844-881-4146. You can also call the phone number on the back of your member ID card. A Health Care Concierge can help you find an urgent care center or a participating provider.
Best Dental Insurance Providers of 2021 Cigna : Best Overall. Renaissance Dental: Runner-Up, Best Overall. Spirit Dental: Best for No Waiting Periods. Humana Dental Insurance: Best Value. UnitedHealthOne Dental Insurance: Best for Families. Physicians Mutual: Best for Seniors. Delta Dental : Best for Orthodontics.
Dental claims should be submitted upon completion of the services provided. Failing to submit the claim on time is an easy reason for the insurance company to deny the dental claim. Most PPO plans require the claim be submitted within one year from the date of service.
The company has been providing insurance since 1954 and offers both PPO and HMO plans. With consistently high ratings for financial stability and more than 150,000 participating dentists across the country, Delta Dental should be one of the first companies you consider for dental coverage .
UPMC for Life plans include preventive dental coverage for oral exams, cleanings, and x-rays. Copay and dental allowance amounts vary by plan View and compare plans by county.
NCQA Health Insurance Plan Ratings 2015-2016 – Summary Report (Medicaid)
|Rating||Plan Name||Consumer Satisfaction|
|4.0||AmeriHealth Caritas Pennsylvania||3.5|
|4.0||Health Partners Plans||3.5|
|4.0||UPMC For You||3.0|
Answer: Coverage for dental services under Medicaid varies between states. Pennsylvania covers necessary dental services, including root canals and crowns. If you do not qualify for Medicaid , you may be able to purchase a dental plan through an insurance exchange.
Medicaid Services Pennsylvania covers 24 optional benefits, including prescription drugs, vision, dental, physical therapy, home health, and hospice care. It also includes the ACA’s ten essential health benefits, such as preventive care, as well as expanded mental health and substance use treatment services.