Your Dental Plan Choices

You have two dental plan choices:

Diversified Dental PPO Plan

Diversified Dental is the largest dental preferred provider organization (PPO) network in our area. This plan gives you the flexibility to see any dental provider, but you save money when you use in-network providers.

LIBERTY DHMO-EPO (Benefit Plan NV-400)

LIBERTY Dental Plan is a dental health maintenance organization (DHMO). LIBERTY Dental Plan contracts with a wide network of private dental offices to provide benefits under this plan. With this plan, you can choose any LIBERTY Dental Plan contracted dentist; however there is no coverage outside of this network. This plan has no annual maximums, no deductibles and $0 to low out-of-pocket costs.

Dental Plan Comparison Chart

Benefit Diversified Dental PPO Plan
In-Network Coverage		 LIBERTY Dental DHMO-EPO Plan
(Benefit Plan NV-400)
In-Network Required
Calendar year deductible None None
Calendar year benefit maximum $2,500 per person None
Preventive care services No cost to you for:
  • Routine annual exam and x-rays
  • Routine cleaning twice/year
 No cost to you for:
  • Routine annual exam and x-rays
  • Routine cleaning twice/year
Basic services You pay 20% See copayment schedule in enrollment packet
Major services You pay 20% See copayment schedule in enrollment packet 
Orthodontia
  • For children under age 19, you pay 20%
  • $1,200 lifetime maximum

Coverage is available for both adults and children; see copayment schedule in enrollment packet

How to Find a Dental Plan Provider

Diversified Dental PPO Plan

Visit ddsppo.com, click “Find a Dentist,” and follow the instructions.

LIBERTY Dental DHMO-EPO Plan (Benefit Plan NV-400)

See the provider list in your enrollment packet, or visit libertydentalplan.com and click the “Find a Dentist” tab and select NV-100 through NV-700 from the Benefit Plan drop-down menu, then follow the instructions. You may also call LIBERTY Dental Plan at 888-401-1128.

Here’s How Dental PPO Providers Save You Money

Diversified Dental PPO providers have agreed to charge discounted, prenegotiated rates for covered services. When you see a PPO dentist, your share of the cost—your coinsurance—is 20% of this special rate. For example, if your bill is $250, you pay $50 and the plan pays the rest.

If you receive out-of-network dental care, your coinsurance remains 20%. However, the amount charged by out-of network providers is not pre-negotiated, so it will likely be higher. Plus, if the provider charges more than what the Fund considers to be the “allowable expense” for that service, you’ll have to pay the difference, too.

Here’s an example:

  • The allowable expense for your dental services is $250, but the out-of-network provider charges $300.
  • You pay 20% coinsurance on the allowable expense, which is $50.
  • You are ALSO responsible for the difference between the provider’s charge and the allowable expense ($300 - $250 = $50).
  • So your total cost for the visit is $100.
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