Fri Oct 9th, 2020
Greetings Southern Ute Tribal Membership,
The Tribal Health Department would like to continue the effort to help individuals understand the sometimes-complex world of health. This article will cover some, but not all basic information of the dental coverage within the department.
All enrolled Southern Ute tribal members have a dental benefit plan that covers many typical dental expenses. This plan is called the Delta Dental plan and it became effective through Tribal Council approval in April 2014. Under Delta Dental, the covered services are oral exams and cleanings (twice each in a 12-month period), sealants once per tooth in a 36-month period for permanent molars in children through age 14, bitewing X-Rays at two sets in a 12-month period, full mouth X-rays at once in a 60-month period, fluoride once in a 12-month period through age 18, space maintainers once per lifetime in children through age 13. Also covered are fillings once per tooth in a 12-month period, crowns once per tooth in a 60-month period, not under age 12, implants once per tooth in a 60-month period, not under age 16, and dentures/bridges one in a 60-mont period only when existing prosthesis cannot be made serviceable.
Each member has a $3,000 annual maximum that runs on a calendar year basis and a $1,000.00 lifetime maximum toward orthodontics. It is important to remember that not all dental services are covered under the Delta Dental plan and there may be out-of-pocket expenses associated with certain services that are not reimbursable by the Tribal Health Department.
We encourage you to communicate with your dentist office to request a pre-determination when a treatment plan is presented to you; this will allow for Delta Dental to review the document and provide coverage to your dentist directly. If you have any questions about your benefits or providers and the Tribal Health Department is unavailable during normal business hours you may also contact the Delta Dental customer service line by dialing 1-800-610-0201 or going to their website at www.deltadentalco.com.
Thank you for your time and please look forward to the next article summarizing your prescription benefits through Silverback RX. The THD Benefits Team is continuing to work through the tribally issues “Stay at Home” Order. Office phones are forwarded to assist the tribal membership between 8 a.m. – 5 p.m. Monday through Friday. We hope that each and every one of you are continuing to stay safe and follow the public health orders issued to help slow or stop the spread of COVID-19.