Understand your healthcare coverage.
About Your Dental Benefits
You and your eligible dependents have the opportunity to enroll in a Dental Health Maintenance Organization (HMO) plan offered by UnitedHealthcare or a Dental Preferred Provider Organization (PPO) plan offered by Delta Dental®. Learn more about how to use your benefits below, according to your plan selection.
Delta Dental PPO™
Available to full-time enrollees of Aetna PPO Plan A and B, the Aetna Medicare Advantage PPO Plan, and the Aetna Open Choice PPO Plan, the Delta Dental PPO Incentive Plan is designed with a tiered structure to increase your benefits as you continue receiving dental care every year. This plan is also designed to give you the freedom to receive dental care from any licensed dentist of your choice. Keep in mind, you’ll receive the highest level of benefit from the plan if you select an in-network PPO dentist versus an out-of-network dentist who has not agreed to provide services at the negotiated rate. Additionally, no claim forms are required when using in-network PPO dentists.
To find an in-network Delta Dental PPO dentist, go to www.deltadentalins.com and search the Provider Network, or call 866.499.3001.
UnitedHealthcare Dental HMO
Available to enrollees of any plan, UnitedHealthcare Dental HMO (Dental Direct) is unique for a DHMO dental plan. Part-time enrollees may only select this plan. You are not required to select a provider as long as you and your dependents go in-network. If you receive services from a provider outside of the approved network, you would be responsible for paying the entire dental bill yourself.
To find a UnitedHealthcare Dental HMO dentist, call 800.999.3367, or go to www.myuhc.com and follow these steps:
- Select “Find A Dentist”
- Type in “Fresno, CA”
- Select “CA Direct Compensation – “
- You can then search by address, city and state, zip code or by provider/dental practice name
- Part-time employees are eligible to enroll in the UnitedHealthcare Dental HMO plan only.
- Dual coverage is not allowed for the same dental plan If both you and your spouse are an employee of Fresno Unified School District and qualify for coverage as a Primary Enrollee, neither of you may enroll as a dependent of the other for the same dental plan. In addition, only one of you may enroll your dependent child(ren) in the same dental plan. However, if you and your spouse enroll in separate dental plans (i.e., one enrolls in Delta Dental and the other enrolls in UHC), you may cover your spouse and dependent child(ren) in each plan.
Coverage
These services are available to Delta Dental PPO and United Healthcare HMO plan members at various rates depending on your plan and choice of in-network or out-of-network care. Learn more about the services listed below and their respective copays in your Benefits packet.
Annual Calendar Year Deductible
Specific deductible amounts, whether referring to an individual, family, or calendar year maximum, vary by plan and can be found in your Benefits packet.
Dental Benefits Coverage
- Preventive Services:
- Office visits
- X-rays
- Cleanings
- Sealants (per tooth)
- Restorative Services:
- Amalgam fillings
- Composite fillings
- Periodontics (Gum Treatment):
- Scaling & root planing
- Gingivectomy (4+ teeth)
- Endodontics (Root Canal Therapy):
- Pulpotomy
- Root canal
- Oral Surgery:
- General anesthesia
- Simple extraction
- Soft tissue impaction
- Complete/partial bony impaction
- Crowns & Inlays:
- Inlay/onlay (2 surfaces)
- Crowns
- Prosthetics & Bridges:
- Bridges
- Denture adjustment
- Complete/partial denture
- Orthodontia Services
- Additional Services:
- Implants
Frequently Asked Questions
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