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Veterans Affairs Dental Insurance Program

Veterans Affairs Dental Insurance Program. Agenda. Introduction Eligibility Enrollment Program Features Premiums Network Dentists Non-Network Dentists Resources Questions?. Introduction. VADIP went into effect on January 1, 2014

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Veterans Affairs Dental Insurance Program

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  1. Veterans Affairs Dental Insurance Program

  2. Agenda • Introduction • Eligibility • Enrollment • Program Features • Premiums • Network Dentists • Non-Network Dentists • Resources • Questions?

  3. Introduction VADIP went into effect on January 1, 2014 Service area includes the U.S., the district of Columbia, Puerto Rico, Guam, the U.S. Virgin Islands, American Samoa, and the Commonwealth of the Northern Mariana Islands Three reasons why Delta Dental’s VADIP is the plan for you: • Dedicated to dental benefits for 50+ years • No deductible options available • Expansive dentist network nationwide

  4. Eligibility Eligible VADIP beneficiaries include • Veterans enrolled in VA healthcare • Individuals enrolled in VA’s Civilian Health and Medical Program (CHAMPVA) Resources • VADIP: www.deltadentalvadip.org • Veterans Affairs: www.va.gov/healthbenefits or 877-222-VETS (8387) • CHAMPVA: www.va.gov/hac/forbeneficiaries/champva/champva.aspor 800-733-8387

  5. Enrollment VADIP website: deltadentalvadip.org Mail application to: Delta Dental of California Federal Government Programs P.O. Box 537009Sacramento, CA 95853-7009 Veteran chooses a plan, submits application, premium prepayment and electronic funds transfer (EFT) information.

  6. Enrollment VADIP enrollment process (continued): • Enrollment commitment • Initial 12-month commitment • Continuing month-to-month • Delta Dental processes application • Coverage begins the first day of the month following acceptance of the enrollment application • Print ID card

  7. Program Features • Three plans to choose from • Expansive dentist network nationwide • Benefit year – January 1 to December 31 • Annual maximums • Standard: $500 • Enhanced: $1,000 • Comprehensive: $1500 • Deductible: • $50 (Standard and Enhanced) • No deductible (Comprehensive) • Coordination of Benefits

  8. Standard Plan • Diagnostic and Preventive – 100% / 80% • Basic Restorative – 50% / 30% • Oral Surgery • 50% / 30% • Simple extractions only • Deductible – $50 • Annual Maximum – $500

  9. Enhanced Plan • Diagnostic and Preventive – 100% / 80% • Basic Restorative – 50% / 30% • Endodontics and Periodontics – 50% / 30% • 12 month wait • Oral Surgery • 50% / 30% • Simple extractions only • Deductible – $50* • Annual Maximum – $1000

  10. Comprehensive Plan • Diagnostic and Preventive – 100% / 80% • Basic Restorative – 60% / 40% • Periodontics, General Services and Oral Surgery – 50% / 30% • Endodontics, Periodontics, Major Restorative, and Prosthodontics – 50% / 30% • 12 month wait • Deductible – $0 in-network / $50 out-of-network • Annual Maximum – $1500

  11. Premiums • Premiums vary by region • 5 premium regions based on zip code • Monthly premiums for 1/1/15 to 12/31/15 • Standard, Enhanced or Comprehensive

  12. VADIP Network Dentists • More cost savings, best value • Accept the “allowed fee” as the maximum billing fee for covered services • Charge only the applicable estimated copayment at the time of service • Submit your claim to Delta Dental at no charge • Two cleanings, two exams and one x-ray in a 12-month period with no copayment (Enhanced and Comprehensive plans only) • Dentist Search button on home page of deltadentalvadip.org

  13. Non-VADIP Network Dentists • Bill you for their normal fees and you pay the difference • Most likely is higher than allowed amount • May not submit paperwork for you • Responsible for full payment upfront

  14. VADIP Resources deltadentalvadip.org Michelle Banks-Gainer Mbanks-gainer@delta.org (757) 368-2217

  15. Questions?

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