Dental Plan Summary
Dental Plan Summary
The Lincoln DentalConnect PPO Plan:
- Covers many preventative, basic, and major dental care services.
- Also covers orthodontic treatment for children.
- Features group coverage for Open Door employees.
- Allows you to choose any dentist you wish, though you can lower your out-of-pocket costs by selecting a network provider.
- Does not make you and your loved ones wait six months between routine cleanings.
Deductible
| In-Network | Out-of-Network | |
|---|---|---|
| Calendar (Annual) Deductible | Individual: $50 Family: $150 Waived for: Preventative | Individual: $50 Family: $150 Waived for: Preventative |
Annual Maximums
| Annual Maximum | $1,000 | $1,000 |
Lifetime Orthodontic Maximum
| Lifetime Orthodontic Maximum | $1,000 | $1,000 |
Waiting Period
| Waiting Period | There are no benefit waiting periods for any service types. |
Per Pay Rates (Semi-Monthly)
| Coverage | Semi-Monthly Rate |
|---|---|
| Employee Only | $11.92 |
| Employee & Spouse | $23.85 |
| Employee & Child/Children | $26.79 |
| Employee & Family | $43.27 |
Covered Services
| Lincoln Dental Connect PPO Plan | In-Network | Out-of-Network |
|---|---|---|
| Preventative Services (no deductible) | ||
| – Routine oral exams | 100% | 100% |
| – Bitewing x-rays | 100% | 100% |
| – Full mouth or panoramic x-rays | 100% | 100% |
| – Routine cleanings | 100% | 100% |
| – Fluoride treatments | 100% | 100% |
| Basic Services (after deductible) | ||
| – Other dental x-rays | 80% | 80% |
| – Space maintainers for children | 80% | 80% |
| – Sealants | 80% | 80% |
| – Problem-focused exams | 80% | 80% |
| – Consultations | 80% | 80% |
| – Palliative treatment (including emergency relief of dental pain) | 80% | 80% |
| – Injections of antibiotics and other therapeutic medications | 80% | 80% |
| – Fillings | 80% | 80% |
| – Prefabricated stainless steel and resin crowns | 80% | 80% |
| – Simple extractions | 80% | 80% |
| – Surgical extractions | 80% | 80% |
| – Oral surgery | 80% | 80% |
| – Biopsy and examination of oral tissue (incl. brush biopsy) | 80% | 80% |
| – General anesthesia and I.V. sedation | 80% | 80% |
| – Prosthetic repair and recementation services | 80% | 80% |
| – Endodontics (including root canal treatment) | 80% | 80% |
| – Periodontal maintenance procedures | 80% | 80% |
| – Non-surgical periodontal therapy | 80% | 80% |
| – Periodontal surgery | 80% | 80% |
| Major Services (after deductible) | ||
| – Bridges | 50% | 50% |
| – Full and partial dentures | 50% | 50% |
| – Denture reline and rebase services | 50% | 50% |
| – Crowns, inlays, onlays, and related services | 50% | 50% |
| – Implant related services | 50% | 50% |
| Orthodontics | ||
| – Orthodontic exams | 50% | 50% |
| – X-rays | 50% | 50% |
| – Extractions | 50% | 50% |
| – Study models | 50% | 50% |
| – Appliances | 50% | 50% |
| In-Network and Out-of-Network Dentists | ||
| To find an in-network dentist near you, visit: www.LincolnFinancial.com/FindADentist. This plan lets you choose any dentist you wish. However, your out-of-pocket costs are likely to be lower when you choose an in-network dentist. For example, if you need a crown… | …you pay a deductible (if applicable), then 50% of the remaining discounted fee for PPO members. This is known as a PPO contracted fee. | …you pay a deductible (if applicable), then 50% of the usual and customary fee, which is the maximum expense covered by the plan. You are responsible for the difference between the usual and customary fee and the dentist’s billed charge. |
To Find a Dentist
To find an in-network dentist near you, visit www.LincolnFinancial.com/FindADentist.
This plan lets you choose any dentist you wish. However, your out-of-pocket costs are likely to be lower when you choose an in-network dentist.
For example, if you need a crown…
In-Network: …you pay a deductible (if applicable), then 50% of the remaining discounted fee for PPO members. This is known as a PPO contracted fee.
Out-of-Network: …you pay a deductible (if applicable), then 50% of the usual and customary fee, which is the maximum expense covered by the plan. You are responsible for the difference between the usual and customary fee and the dentist’s
billed charge.
Get Connected with Lincoln DentalConnect Plans
Register for online tools and information in 3 easy steps:
If you’re covered by a Lincoln PPO or indemnity group dental plan, you can access a wide range of online dental health information.
- Go to LincolnFinancial.com, and click LOG IN/REGISTER in the top navigation on the home page.
- Select REGISTER.
- Follow the prompts to complete your registration and log in to your account.
Online tools and resources available to manage your dental care:
- Print your ID Card
- Check your claim status
- Get directions to your dentist’s office
- Estimate the average cost of a dental procedure
- Have your questions answered by a licensed dentist
- Switch between English and Spanish versions in just 1 click
- Catch up with the latest dental news, trends, and developments
- Access an in-depth database on a full array of dental health topics
Lincoln Dental Mobile App
Lincoln dental insurance is simple and convenient, and now keeping track of your plan is just as easy with the Lincoln Dental Mobile App.
With the Lincoln Dental App, you can:
- Find a network dentist near you in minutes
- Have an ID card on your phone instead of digging for it
- Customize the app to get details of your plan
- Find out how much your plan covers for checkups and other services
- Keep track of your claims
- See what was covered and what you owe for your last trip to the dentist
Download the Lincoln Dental Mobile App from the Apple App Store or Google Play Store.
Using Your Dental Insurance
When you call to schedule your visit, let the office know that you have coverage through Lincoln Financial Group with the Lincoln DentalConnect PPO Plan.
Have your member ID card handy when you call so you can provide information listed on the card – or your social security number – to help the office verify your coverage.
Questions?
Please contact Lincoln customer service at 1-800-423-2765.
