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Dental & Hearing Benefits Boosted Again!

There are exciting recent enhancements to your Welfare Fund dental and hearing aid benefits:

Dental Benefit Improvements

Guardian Network Dentists: Crowns, Implants, Oral Surgery and Orthodontics

Following on last year's increases to the reimbursements for a wide range of dental procedures, on July 1, 2018, the Fund’s reimbursement schedule for many common but expensive procedures—when provided by participating, in-network Guardian dentists—was further enhanced. 

The Fund targeted resources to the most common expensive procedures: dental implants, oral surgery, crowns, and orthodontics. The new schedule of reimbursements will cover a broader range of dental codes associated with each of these procedures and cover them at a higher reimbursement rate. 

Remember that by choosing a Guardian network dentist, you can save hundreds of dollars on common procedures because Guardian-participating dentists discount their fees by 30% to 40% to our members. The Fund then pays for a portion of the dentist’s actual charge.
 
The table below shows the projected percentage increase in coverage for the average charge of in-network Guardian dentists. 

 

Procedure Current Coverage of Avg.
Guardian Dentist Charge
New Projected Coverage of Avg. Guardian Dentist Charge
Dental Implants 62.2% 76.4%
Oral Surgery 84.2%  86.6%
Crowns 68.5%  86.5%
Orthodontics 54.1% 75.0%

See the enhanced Guardian reimbursement schedule.

In-Network and Out-of-Network: Coverage for Three Cleanings per Year

The Fund will also increase coverage of adult cleanings from two-times per year to three-times per year at current rates for both in-network and out-of-network dentists. Some members require more than two cleanings per year to maintain oral health and prevent serious dental conditions from arising. Fund Trustees want to provide this option when needed.

Hearing Benefit Improvements

Last year the Fund contracted with the Hear USA network to provide a major improvement in the Fund’s hearing benefit--$750 per ear for in-network hearing aids.  Eligible members and their dependents now receive significant discounts on hearing aids, and the Fund provides a $1500 per-ear in-network subsidy on top of the discount for a total subsidy of $3,000 once every 36 months.
 

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