Administered by Delta Dental, 1-866-579-5717

Who is Eligible?

Benefits eligible employees, COBRA enrollees, and their eligible dependents.

Benefits eligible employees enrolling in the Choices Medical Plan must elect a Dental Plan (Basic Plan or Select Plan).  Note: the Basic Plan provides coverage for a limited range of services including diagnostic and preventive services. 

During Annual Enrollment, benefits eligible employees may change their Dental Plan option and add eligible dependent children to the Dental Plan.  Important Note:  Annual Enrollment for the Plan Year is Closed Enrollment for a legal spouse for Dental coverage unless there is a qualifying event.

MUS dental claims are reimbursed based on a fixed dental fee schedule.  The fee schedule’s fixed dollar amount is the maximum reimbursement amount paid by the Plan for the specified dental procedure code,  regardless of provider network.  Covered Dental Plan enrollees are responsible for the difference (if any) between the provider's charge and the fee schedule’s reimbursement amount.

MUS Dental Plan enrollees have the freedom of choice to visit any licensed dentist, however, out-of-pocket costs may be reduced if utilizing a Delta Dental Premier or PPO network dentist.

Refer to the Summary Plan Description (SPD) on the Choices home page for complete Dental Plan benefits, annual maximums, limitations, exclusions, and fee schedule information.

 
Basic Plan Coverage
Select Plan Coverage
Annual Benefit Maximum $750 per covered individual $2,000 per covered individual
Diagnostic & Preventive Services

Twice Per Benefit Year:

  • Initial and periodic oral exam
  • Cleaning
  • Complete series of intraoral X-rays

Twice Per Benefit Year:

  • Initial and periodic oral exam
  • Cleaning
  • Complete series of intraoral X-rays

**The above do not apply to the $2,000 annual benefit maximum
Basic Restorative Services
  • Not covered
  • Amalgam filling
  • Endodontic treatment
  • Periodontic treatment
  • Oral surgery
  • Removal of impacted teeth
Major Dental Services
  • Not covered
  • Crown
  • Root canal
  • Complete lower and upper denture
  • Dental implant
  • Occlusal guards
Orthodontia Services
  • Not covered
  • $1,500 lifetime benefit maximum/individual
**The above does not apply to the $2,000 annual benefit maximum

 

Orthodontic Benefit
Benefits are paid at 50% of the allowed amount for covered services. Treatment plans usually include an initial down payment and ongoing monthly fees. If an initial down payment is required, the Plan will pay up to 50% of the initial payment, up to 1/3 of the total treatment charge. In addition, Delta Dental (Dental Plan Administrator) will establish a monthly reimbursement based on the provider’s monthly fee and the prescribed treatment plan.