Health Economics Group - MVP Health Care
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2018 Dental Benefit Coverage

 

Please Note: The following benefit information applies to members who pay MVP directly for their GoldValue with Part D (HMO-POS), Preferred Gold with Part D (HMO-POS), or GoldPPO with Part D (PPO) plans, SmartFund MSA members who purchase the Optional Rider, and members with coverage through a former employer that has purchased additional dental coverage. See your Evidence of Coverage (your contract) or plan Riders for more information.

 

How your dental benefit works:

  • The plan covers up to a set benefit amount per calendar year for covered dental services.
  • The amount the plan pays for covered services is based on the maximum allowable benefit for each service. The maximum allowable benefit amounts are determined by MVP.
  • You are responsible for 100% of all charges once the annual benefit amount under your plan is reached, any charges above the maximum allowable benefit amount per service, or for any dental services not covered under your benefit.
  • No unused portion of your annual benefit amount can be carried over to the next calendar year.
  • You will receive a separate dental ID card. Show this card when you receive dental services.

DenteMax Network Fees
 General Dentists' Fees
 (Specialists' fees may be higher)

 

Dental Network:

You can choose to go to any dentist. Under your dental benefit, you also have access to the DenteMax group of dentists.

  • Generally your costs will be lower if you are treated by a DenteMax dentist.
  • DenteMax dentists accept the maximum allowable benefit amount per service as payment in full. You will not be billed for additional costs for dental services covered by the plan.
  • If you choose to go to any other dentist, you may pay more. The dentist can bill you for additional costs if what they charge is more than the maximum benefit amount for preventative services covered by the plan.

Find a DenteMax Dentist

Select Network Type:
Individual Membership


In addition to the benefits offered as part of your MVP plan, you can also see a DenteMax dentist for additional dental services that are not covered by this benefit for a lower cost to you. You have access to a group of more than 100,000 dentists and dental practices throughout the United States. Show your dental ID card with the DenteMax logo to receive services.

If you have questions about your dental benefit or the DenteMax group of dentists, call the MVP Medicare Customer Care Center at 1-800-665-7924 (TTY users may call 1-800-662-1220). Representatives are available Monday - Friday, 8 am - 8 pm Eastern Time. From October 1 - February 14, please call from 8 am - 8 pm, seven days a week. The Customer Care Center phone numbers are also on the back of your dental ID card.

Note: We cannot guarantee that a particular dentist will accept DenteMax fees as payment in full. Confirm network participation and fees before receiving treatment. Note that specialists and some general dentists may charge higher fees than shown in the fee schedules. We rely on the judgment of DenteMax as to the professional competency of dentists in their network.

For an explanation of the importance of dental networks and for information about dental fees in your geographic area and throughout the entire United States, see the materials prepared by FAIR Health, Inc. at www.fairhealthconsumer.org.

MVP Health Plan, Inc. is an HMO-POS/PPO/MSA organization with a Medicare contract. Enrollment in MVP Health Plan depends on contract renewal. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or copayments/coinsurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium. The provider network may change at any time. You will receive notice when necessary.


Y0051_3623 Pending
Last Updated October 2017

 

Health Economics Group, Inc.
1387 Fairport Road
Building 1000 - Suite A-1
Fairport, New York 14450
 585-241-9500x501 or 1-800-666-6690x501