Macalester
Oral health is an important component of overall health and well-being. Most dental problems are preventable. Preventive care, including regular check-ups and cleanings, is the key to maintaining good oral health. Problems can be diagnosed early and treated without extensive testing or elaborate and expensive procedures. Additionally, regular dental check-ups may surface other health issues. Macalester offers two dental insurance plan options through Delta Dental.
Frequently Asked Questions
Who is eligible to be covered under Macalester’s dental plans?
Any regular Macalester employee scheduled to work 1007.50+ hours (0.50 full time equivalent (FTE) or higher) is eligible for coverage.
Who can I add to my dental plan?
- Spouse
- Registered domestic partner (see Declaration of Domestic Partnership form)
- Dependent children (up to age 26; see IRS guidelines)
- Other legal dependents (see IRS guidelines)
What is the difference between “PPO”, “Delta Premier” and “out of network” providers/doctors?
“PPO” and “Delta Premier” are networks of providers with Delta Dental. A provider in one of these networks will provide coverage typically provides the full benefit allowed under the plan.
“Out of network” coverage allows you to see any provider/doctor of your choosing, however at a lower benefit level (higher cost to you).
Can I choose my own dentist?
Yes. Similar to the medical plans, you can choose any dentist you would like. However under the dental plans, benefit levels are determined whether your dentist is a Delta Dental PPO, Delta Dental Premiere or Out-of-Network participating dentist. To review your dentist’s participation level with Delta Dental Go to Delta Dental of Minnesota – Dentist Search.
Can I elect Preventive Dental for myself and Comprehensive Dental for my dependents?
No. All participants must be covered by the same dental insurance.
Can I participate in a health plan and not elect to participate in dental through Delta Dental?
Yes. Employees participating in a health plan can elect to have no dental insurance coverage. All dental coverage is separate from the health plan and is through Delta Dental.
Will I receive a new dental insurance card?
Participants who change their dental insurance election will receive new dental insurance cards from Delta Dental.
What if I would like access to complete dental services such as filings, restorative services, orthodontic services, etc.?
If you would like access to comprehensive dental services, you can elect the Delta Dental “Comprehensive Dental” coverage option.
2019 Dental Plan Employee Premiums
| Coverage Level | Preventive | Comprehensive |
|---|---|---|
| Employee | $4.36 | $24.53 |
| Employee + 1 | $13.10 | $57.71 |
| Employee + 2 or more | $21.41 | $92.44 |
Note: Rates shown are per month
Dental Plan Coverage Summary
Preventive Dental
| Service/Feature | PPO | Delta Premier | Out of Network |
|---|---|---|---|
| Annual Max Benefit | Unlimited | Unlimited | Unlimited |
| Annual Deductible | $0 | $0 | $0 |
| Diagnostic & Preventive Exams, cleanings, x-rays, sealants |
Covered at 100% | Covered at 100% | Covered at 100% |
Note: The above table is a summary only. The certificate of coverage will be used in case of error and for all claims processing.
Comprehensive Dental
The Comprehensive Dental Plan pays up to an annual maximum benefit amount (i.e. $1,250 for Delta Dental Premier participating dentists) for all combined services for each Covered Person per Coverage Year subject to the coverage percentages identified below. A Coverage Year is a 12-month period in which deductibles and benefit maximums apply. The Coverage Year is January 1 to December 31.
| Service/Feature | PPO | Delta Premier | Out of Network |
|---|---|---|---|
| Annual Max Benefit | $1,500 | $1,250 | $1,000 |
| Annual Deductible Not applicable to preventive and diagnostic |
$0/person; $0/family |
$25/person; $75/family |
$50/person; $150/family |
| Diagnostic & Preventive Exams, cleanings, x-rays, sealants |
Covered at 100% | Covered at 100% | Covered at 100% |
| Basic Services Fillings, emergency treatment for pain |
Covered at 80% | Covered at 50% | Covered at 50% |
| Endodontics, Periodontics Root canals |
Covered at 75% | Covered at 50% | Covered at 50% |
| Oral Surgery Extractions |
Covered at 75% | Covered at 50% | Covered at 50% |
| Prosthetics Denture adjustments, repairs |
Covered at 50% | Covered at 50% | Covered at 0% |
| Major Restoratives Dentures, resins, crowns |
Covered at 50% | Covered at 50% | Covered at 0% |
| Orthodontics $1,000 lifetime maximum |
Covered at 50% | Covered at 50% | Covered at 0% |
Note: The above table is a summary only. The certificate of coverage will be used in case of error and for all claims processing.
Resources
- Visit deltadentalmn.org
- Call 651-406-5916 or 800-448-3815 (Toll Free)
- Delta Dental Online Tools
- Delta Dental Claim Form