Dental
In general, the Plan covers necessary dental expenses at 80% of the usual and customary charges for services rendered, subject to the annual deductible and maximum benefit, the treatment plan requirement, and other specific limitations.
The Dental Benefit is available to all active employees and their covered dependents, as well as retirees who have chosen dental and vision coverage and their covered dependents.
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Dental Network of America
LINECO uses a dental preferred provider organization (PPO) called the Dental Network of America (DNoA). Use of a PPO provider is voluntary.
To find a DNoA dentist, go to www.dnoa.com or call 1-(866)-522-6758 between 7:30 a.m.–6 p.m. CST.
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Treatment Plan
Have your dentist submit a treatment plan and request a pre-treatment estimate prior to beginning work which will total more than $1000. This way you will be sure of what the Plan will cover before you receive treatment.
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Dental Calendar Year Deductible
$100 per Covered Person, waived on preventative services.
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Dental Calendar Year Maximum Benefit
$2,000 per Covered Person — all services apply to max except preventative care for children under age 21.
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Patients Age 0-20 Dental Calendar Year Maximum Benefit
$2,000 per Covered Person
Exclusion: See Diagnostic and Preventative
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Patients Age 0-20 Diagnostic and Preventive:
Exams, x-rays, fluoride*, cleanings, sealants*
100%
No deductible
No maximum* Fluoride is covered up to age 18, Sealants are covered up to age 15.
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Restorative Dental
Fillings, root canals, periodontal work, extractions, anesthesia, crowns, dentures, bridgework, implants, and oral surgery.
80%
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Orthodontics - Dependent children only
80%; up to $2,000 lifetime maximum
No deductible