The following questions and answers are intended to support dental patients who are insured by Unity UW Health Insurance and are learning about changes for 2012 to the dental insurance associated with Unity Health Insurance. We hope you'll find this information helpful, and that it helps you make informed decisions during open enrollment period, which ends October 28.
What is all this about the change to dental coverage for Unity UW Health insured individuals?
The dental coverage associated with Unity Health Insurance will change, effective 1/1/12 from Delta Dental to Momentum. This means that in order to receive coverage, patients must go to Momentum providers or carry supplemental dental insurance in order to be covered by First Choice Dental after the first of the year.
When does this change take effect?
However, open enrollment is October 3-28, 2011, so decisions that could affect your coverage are the ones you’re making right now. You’ll be able to use your current benefits through the end of 2011, and can continue to make appointments to utilize remaining 2011 benefits through the end of this plan year.
Why are you telling me this?
We’ve been receiving calls from patients who are concerned about changes to their dental health coverage for 2012. While First Choice Dental is not responsible for this change and is not able to control changes that employers or insurance providers make to benefits, we can appreciate our patients’ concern. We wanted to provide some information that may be helpful for you. Our primary concern is to continue to be able to provide superior dental health care to as many of our valued patients as possible.
Why is this important right now?
Because the open enrollment window is closing soon, before the end of October. We wanted to give you a heads up that changes are coming for Unity insured individuals, so that you have the opportunity to read your enrollment materials carefully and direct questions to your insurance provider or to your benefits specialist.
Will all state employee insurance plans be affected?
No. Only those with Unity UW Health insurance are affected.
Will I have to change dentists?
That depends. If you have Unity UW Health Insurance and do not elect to have supplemental dental insurance, you will need to see Momentum providers in order to have those services covered. If you have supplemental dental insurance or elect to have supplemental dental insurance during this year’s annual choice of coverage or open enrollment period, you will have more choices for providers, as well as covered services.
What do I need to do?
It’s open enrollment time. Consider what your family needs and weigh this as you select your 2012 health insurance options. If you have specific questions about how your coverage could change, talk to your insurance provider or benefits specialist.
Are you going to be providers for Momentum?
No. First Choice Dental was not provided with an opportunity to be a network provider for Momentum and does not have that option at this point.
What if I am a First Choice Dental patient right now, and don’t want to switch?
If you have Unity UW Health, consider supplemental coverage. We’re premier providers for Delta Dental as well as many other insurance providers. State employees’ supplemental dental insurance is with Delta. You may know this supplemental coverage as Dental Wisconsin or Epic Benefits+. These are both administered by Delta Dental.
If I already have supplemental insurance, what’s the impact to me?
As we understand it, there are minimal changes for 2012 to the supplemental insurance plans associated with your Unity UW Health insurance. You will continue to receive the same or similar benefits currently covered by your supplemental policy. However, since there are changes being made to your primary dental insurance coverage, you’ll want to make sure that between your primary and supplemental dental insurance coverage, you’re getting what you need. To confirm or get more detailed information, you should ask your benefits specialist or insurance provider.
Should I consider supplemental insurance if I don’t already have it?
Quite possibly. Most of our dental patients who currently have Unity UW Health Insurance DO elect to carry supplemental insurance. The need to carry supplemental insurance in 2012 may increase since Momentum is a “limited preventative and restorative services insurance plan”. In other words, it may not cover all of the dental services that a typical individual or family needs. In order to determine if you or your family will need supplemental coverage, you should read your open enrollment materials carefully and ask good questions of your insurance provider or benefits specialist, such as:
- What will this plan cover and at what percentage?
- What is NOT covered? (plan “exclusions” or “limitations”)
- For services covered, are “equivalent amounts” allowed (for instance if the plan will only cover metal/amalgam fillings, can you get an equivalent amount toward tooth-colored fillings? Are these types of substitutions allowed?)
- Who is in-network for Momentum?
- How quickly could I be seen for care as a brand new patient with a Momentum provider?
Is supplemental insurance a good value?
That’s your personal decision and depends on your unique dental health situation. From the information we’ve seen about 2012 Unity UW Health Insurance benefits, it appears that supplemental coverage can be purchased for as little as around $17-25/month for an individual, or $60 for a family. Depending on your dental health needs, this may be worthwhile. First Choice Dental is a provider in nearly all of the supplemental options being offered for 2012.
What if I have more questions?
Talk to your employer’s benefits specialist. Read your insurance enrollment materials carefully so that you can make good, informed decisions before the end of open enrollment, which is happening in the next few weeks. Contact your insurance provider. If you have questions about treatment plans already underway with First Choice Dental or diagnosed treatment that you’d planned to have done in 2012, please call us and we will answer whatever questions we can in order to make this process as easy as possible for you.
