Dental benefits for Consumer Driven Option members

Anyone who is eligible to sign up for an APWU Health Plan can enroll in the APWU Health Plan Dental Insurance Plan. Members pay a separate premium for this plan and can use any dentist they choose. There is no deductible for preventive services, including exams, X-rays, and cleanings. A $50 deductible per person applies to basic and major services. The Plan pays 80% of the reasonable and customary charges for basic services and 50% of the reasonable and customary charges for major services.

Consumer Driven Option Plan members receive a Personal Care Account to help pay for eligible medical services, including covered dental expenses. You’ll pay for dental services at the time of service. Each calendar year, dental services are reimbursable out of your PCA up to a combined maximum of $400 per Self Only enrollment or $800 per Self Plus One and Self and Family enrollment.

The Voluntary Benefits Plan Dental Program is an optional program with an additional premium that supplements the dental benefits in your APWU Health Plan coverage. The cost of these benefits is not included in the FEHB premium and any charges for these services do not count toward any FEHB deductibles or out-of-pocket maximum co-pay charges, etc. These benefits are not subject to the FEHB disputed claims review procedure.

All participants in the APWU Health Plan who enroll in the Voluntary Benefits Plan Dental Plan will receive discounted premiums for this program versus the general public. You can sign up for this plan either during enrollment in your health plan, or at any time throughout the year.