Moosilauke Visions offers a dental plan administered by Northeast Delta Dental.
Although you can choose any dental provider, when you use an in-network dentist, you will generally pay less for treatments because your share of the cost will be based on negotiated discount fees. With out-of-network dentists, the plan will pay the same percentage but the reimbursement will be based on out-of-network rates. You may be billed for the difference.
New Dental Plan Changes for 2023:
Orthodontia will be offered under both the base and buyup plans, for both children and adults!
Dental Plan Comparison
| Benefit Description | In-Network | Out-of-Network1 |
|---|---|---|
| Delta Dental Base Plan | ||
| Annual Deductible | $25 / $75 per member / family | $25 / $75 per member / family |
| Waived for Preventive Care? | Yes | Yes |
| Annual Maximum Dental Benefit | $1,000 | $1,000 |
| Preventive Care Services | 100% | 100% |
| Basic Services | 80% | 80% |
| Major Services | 50% | 50% |
| Orthodontic Benefits | 50%, adults and children | 50%, adults and children |
| Orthodontia Lifetime Maximum | $1,000 | $1,000 |
| Delta Dental Buy Up Plan | ||
| Annual Deductible | $0 / $0 per member / family | $0 / $0 per member / family |
| Waived for Preventive Care? | Yes | Yes |
| Annual Maximum Dental Benefit | $2,000 | $2,000 |
| Preventive Care Services | 100% | 100% |
| Basic Services | 90% | 90% |
| Major Services | 50% | 50% |
| Orthodontic Benefits | 50%, adults and children | 50%, adults and children |
| Orthodontia Lifetime Maximum | $1,000 | $1,000 |
Employees can elect the medical and prescription drug plan without enrolling in the dental or vision plan.
1. Subject to balance billing.
Biweekly Employee Payroll Contributions
| Employee | Employee & Spouse | Employee & Child(ren) | Employee, Spouse & Children (Family) |
|
|---|---|---|---|---|
| Dental PPO Base | $7.97 | $13.27 | $14.39 | 21.50 |
| Dental PPO Buy Up | $10.33 | $15.50 | $16.34 | $24.42 |
Contact Information:
800.537.1715
nedelta.com/patients/
Group Number: 1577
Dental exams can tell your doctor a lot about your overall health. It’s important to schedule regular exams to help detect significant medical conditions before they become serious.
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