Routine preventive care such as regular dental checkups can help lower your risk of stroke and heart disease. Air Medical Group Holdings’ dental coverage will provide you and your family affordable options for overall health. Coverage is available from Delta Dental.
Network Dentists
Your Plan’s in-network dentists have agreed to charge lower fees, which helps keep money in your pocket. If you choose to use a dentist who doesn’t participate in your Plan’s network, your out-of-pocket costs will be higher, and you are subject to any charges beyond the Reasonable and Customary (R&C). To find a network dentist, visit Delta Dental at www.deltadentalins.com.
Dental Premiums
Premium contributions for Dental will be deducted from your paycheck on a pre-tax basis. Your tier of coverage will determine your biweekly premium.
| DELTA DENTAL PPO | |
| BIWEEKLY CONTRIBUTIONS | |
| Employee Only | $13.61 |
| Employee + Spouse | $28.57 |
| Employee + Child(ren) | $25.16 |
| Employee + Family | $49.66 |
Dental Plan Summary
Dental Plan benefits are available to you on a voluntary basis. The chart below gives a summary of the 2017 dental coverage provided by Delta Dental. All out-of-network services are subject to Reasonable and Customary (R&C) limitations.
| DELTA DENTAL PPO | |
| IN-NETWORK & OUT-OF-NETWORK | |
| CALENDAR YEAR DEDUCTIBLE | |
| Individual | $50 |
| Family | $150 |
| CALENDAR YEAR MAXIMUM | |
| Per Person | $2,000 |
| COVERED SERVICES | |
| Preventive Services Oral Evaluation, Bitewings, Prophylaxis, Flouride Treatments, Sealants, Consultations, Space Maintainers | No copay/coinsurance |
| Preventive Services Amalgam or Composite Resin Restoration, | 20%* |
| Major Services Prosthodontics, Crowns, Inlays, Onlays, Dental Implants | 50%* |
| Orthodontics Dependent Child(ren) Only to age 19 | 50% |
| Orthodontics Lifetime Maximum | $2,000 |
Please note: There is a 12-month waiting period before orthodontic services are covered.