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Veterans Affairs Dental Insurance Program

Veterans Affairs Dental Insurance Program. VADIP Presentation 02/14. Agenda. Introduction Eligibility Enrollment Program Features Premiums Network Dentists Non-Network Dentists Resources Questions?. VADIP Presentation 02/14. 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 VADIP Presentation 02/14

  2. Agenda • Introduction • Eligibility • Enrollment • Program Features • Premiums • Network Dentists • Non-Network Dentists • Resources • Questions? VADIP Presentation 02/14

  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 VADIP Presentation 02/14

  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 VADIP Presentation 02/14

  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. VADIP Presentation 02/14

  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 • No enrollment card required VADIP Presentation 02/14

  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 VADIP Presentation 02/14

  8. Standard Plan • Diagnostic and Preventive – 100% / 80% • Basic Restorative – 50% / 30% • Oral Surgery • 50% / 30% • Simple extractions only • Deductible – $50 • Annual Maximum – $500 VADIP Presentation 02/14

  9. Enhanced Plan • Diagnostic and Preventive – 100% / 80% • Basic Restorative, Endodontics and Periodontics – 50% / 30% • Oral Surgery • 50% / 30% • Simple extractions only • Deductible – $50* • Annual Maximum – $1000 VADIP Presentation 02/14

  10. Comprehensive Plan • Diagnostic and Preventive – 100% / 80% • Basic Restorative – 60% / 40% • Endodontics, Periodontics and General Services – 50% / 30% • Oral Surgery – 50% / 30% • Major Restorative and Prosthodontics – 50% / 30% • 12 month wait • Deductible – $0 • Annual Maximum – $1500 VADIP Presentation 02/14

  11. Premiums • Premiums vary by region • 5 premium regions based on zip code • Monthly premiums for 1/1/14 to 12/31/14 • Standard, Enhanced or Comprehensive VADIP Presentation 02/14

  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 VADIP Presentation 02/14

  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 up front VADIP Presentation 02/14

  14. VADIP Resources deltadentalvadip.org Lynn Jamroz ljamroz@delta.org 630-587-6397 VADIP Presentation 02/14

  15. Questions? VADIP Presentation 02/14

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