Tuality Select/Employee Plan
Oregon Health PlanDental Plans
The following Dental Plan options are provided by the Tuality Healthcare Benefits program and are administered by ODS. The datetimermation provided here is only a summary. Please refer to your dental benefit booklet for details on your dental plan coverage's or contact ODS directly.
Preventative Plan
Under this plan, you can choose to see any licensed dental provider. After you pay a $50 per person annual deductible, the plan will pay a percentage (coinsurance) of covered expenses, up to $1,500 per person per year. There is no deductible required for diagnostic/preventive care.
Incentive Plan
Under the Incentive plan, you can also choose to see any licensed dental provider. There is no annual deductible. The plan pays a percentage of covered services, up to $1,500 per person per year. For certain preventive and restorative care, the plan pays a higher benefit for each year you receive care. For instance, during your first year in the Incentive Plan, if you receive a routine dental exam, the plan will pay 70% of your covered expenses. In the second year, the plan will pay 80% for the same service. In the third year, the plan pays 90%. After the third year, the plan will pay 100% of routine exams.
Comparison of Covered Services by Plan
| Plan Features | Preventive Plan | Incentive Plan |
| How the plan works | Plan pays benefits from any licensed dental provider. | Plan pays benefits from any licensed dental provider. |
| Annual Deductible | $50 per person (no deductible for diagnostic/preventive care). | None. |
| Maximum Annual Benefit | $1,500 per person. | $1,500 per person. |
| Orthodontia | 50% (no deductible, lifetime benefit of $1,500 per person). | Not Covered. |
Diagnostic/Preventive Care
|
100% | Coverage level increases each calendar year a participant receives care:
|
Restorative/Oral Surgery
|
80% after deductible. | Coverage level increases each calendar year a participant receives care:
|
Restorative/Prosthodontic
|
50% after deductible. | 50% |