Dental Cover for Uk Based Civilians and Dependants and Military Dependants

DENTAL COVER FOR CIVILIANS & THEIR DEPENDANTS AND FOR MILITARY DEPENDANTS * This guidance does not apply to military active duty * * You must ensure that the dentist you are visiting is in network with Dentemax. This should be checked by contacting Dentemax (www.dentemax.com or 1-800-752-1547), rather than asking the dental office. If the dentist tells you they are in network and this is not confirmed by Dentemax, you will be responsible for the full cost of your treatment. This includes referrals. The specialist that your dentist has referred you to must also be in the Dentemax network * * No routine dental care is funded during the first & last 3 months of your/your spouse’s tour * Attending your appointment  When asked for your insurance at the dental office, present your Meritain Health ID card. Covered treatment  See overleaf for a listing of covered adult and child treatments.  If you have any treatment that requires authorisation before approval has been received, or you have any non-covered treatment, this will be a personal expense. Authorisation process  If the treatment recommended by your dentist requires authorisation from Meritain Health, they must send x-rays and a treatment plan to Meritain Health: Meritain Health P.O. Box 27267 Minneapolis, MN 55427-0267 It takes around 2 weeks to receive a response from Meritain Health from the time that they receive the case materials. The Healthcare Dept will inform you (or your spouse if you are a dependant) of the decision. Meritain Health will also inform your dentist what treatment has been authorised.  If the treatment requires authorisation from Defence Dental Services in the UK, a BDS-US Form 210 (included at the end of this handout) must be completed (page 1 by the employee, and pages 2-3 by the dentist). The form, along with case materials including x-rays, clinical photographs, dental models and a treatment plan must be sent to: Healthcare Department North American Support Group British Defence Staff – United States British Embassy 3100 Massachusetts Avenue NW Washington, DC 20008-3600 It can take 4-8 weeks to receive a response from Defence Dental Services. The Healthcare Department will notify you (or your spouse if you are a dependant) of the decision. Emergency treatment  All emergency work MUST be completed by a Dentemax dentist.  All emergency treatment to relieve pain and discomfort (including temporary crowns) will be funded without prior approval. Any follow up treatment, including permanent treatment, requires approval. Charges  Adults will be charged a co-pay for treatment. The remainder of the bill will be paid for by Meritain Health. You will only be charged one co-pay for a course of treatment.  There are 3 bands of co-pays (equivalent to NHS contributions in the UK) for adults (see overleaf).  There are no co-pays for children. All routine children’s treatment will be paid for in full by Meritain Health. COVERED ADULT TREATMENTS No authorisation required  1 routine check-up every 12 months (includes an oral exam, prophylaxis (basic clean & polish) and x-rays as required)  Up to 3 fillings  Root canals Authorisation required from Meritain Health  Crowns  Crown build-ups  Periodontal work (including deep cleaning)  Bridges  Dentures  Onlays Authorisation required from Defence Dental Services in the UK  Multiple wisdom teeth extractions  Any single course of treatment costing over $5,000 Not covered  Fluoride treatment  Orthodontic treatment  Sealants  Antimicrobial injections  Implants  Veneers

COVERED CHILD TREATMENTS No authorisation required  1 routine check-up every 6 months (includes an oral exam, prophylaxis (basic clean & polish) and x- rays as required)  Fluoride treatment (1 treatment every 6 months)  Sealants  Fillings Authorisation required from Meritain Health  Silver crowns on baby teeth  Extraction of baby teeth Authorisation required from Defence Dental Services in the UK  Orthodontic treatment  Wisdom teeth extractions

ADULT CO-PAYS (NHS CONTRIBUTIONS) Band 1 - $28.00 ( £18.00)  Routine check-up (inc. exam, cleaning & x-rays), emergency exam, initial exam with a specialist Band 2 - $75.00 ( £49.00)  Fillings, extractions, root canals, periodontal cleaning and scaling Band 3 - $330.00 ( £214.00)  Crowns, crown build-ups, dentures, bridges, onlays

THIS DOCUMENT WILL BE REVIEWED EVERY THREE MONTHS, AND IS AVAILABLE ON DESTINY. PLEASE CHECK DESTINY PERIODICALLY TO SEE IF ANY UPDATES HAVE BEEN MADE. CURRENT AS AT: 1st MAY 2013 1 2 3