If you use a participating dentist

The Fund has a contract with all of the participating dentists which guarantees the fees for the services the dentist performs.  For most diagnostic, preventive, and basic restorative care, the contracted rate is accepted as payment in full.  Your participating dentist bills the Fund directly for the services and you make no payment.  For other types of services, you and the Fund share the cost.  The maximum amount your participating dentist can charge for any service is established in a fee schedule.  When you receive one of these services, the participating dentist bills the Fund for its portion (which is the majority of the cost) and charges you for the remaining balance.  For a complete dental schedule, contact the Fund office.

If you use a non-participating dentist

The Fund will reimburse you for eligible services based on a schedule of allowances.  In most cases, the amount payable from the Fund will be less than your dentist charges, and you will be responsible for paying the difference.  Your out-of-pocket costs will be more than if you had used a participating dentist.  The cost to you will vary depending on how much your dentist charges.  For a complete dental schedule, contact the Fund office.

Maximum payments

Whether you use a participating dentist or a non-participating dentist, the maximum amount the Dental Plan will pay for all covered services (except orthodontics) in any calendar year is $1,500 per person.  (The lifetime allowance for orthodontic cases is a separate maximum and does not count toward the $1,500 per person calendar year maximum.)