Dental InsuranceDental coverage is provided through Delta Dental of Virginia. The LCPS plan is a PPO and is part of the Premier and Preferred networks. Coverage is provided for both in-network and out-of-network services and are based on a Plan Year of January through December.In-NetworkPreventitive Services: Covered 100% (2 visits per year)Basic Services: Covered at 80% after a $50.00 deductible ($150.00 family)Major Services: Covered at 80% after a $50.00 deductible ($150.00 family)Out-of-NetworkPreventitive Services: Covered 80% of Usual and Customary Rates (UCR) (2 visits per year)Basic Services: Covered at 60% of UCR after a $50.00 deductible ($150.00 family)Major Services: Covered at 50% of UCR after a $50.00 deductible ($150.00 family)Benefit MaximumsAnnual benefit maximum for Basic and Major services is $1,250.00 per enrollee per contract year. The benefit maximum is cumulative between in and out-of-network benefits.Orthodontics are covered at 50% of UCR up to a lifetime maximum of $1000 per person for both in-network and out-of network.Healthy Smile, Healthy You ProgramIf you are pregnant, have diabetes, have certain high-risk cardiac conditions or are receiving chemo or radiation for cancer, you are eligible for an extra cleaning and exam beyond our plan's normal annual limit. Click here for more information on the program and find the Healthy Smile, Healthy You enrollment form under Infomation, Forms and Resources on the right side of this page.
Vision coverage is provided through Davis Vision for routine eye exams, glasses or contact lenses.In-Network: $15 co-pay: $15 co-pay (Additional fees will apply for extra coatings and specialty lenses)Frames: A credit of $110 is provided towards the purchase of frames ($160 credit at Visionworks)Contact Lenses: $100 allowance towards a year supply of contact lenses in lieu of eye glass lensesInformation, Forms and Resources
Delta Dental Contact InformationMember Services:1-800-237-6060Website:Claims Address:Delta Dental of Virginia4818 Starkey Rd.Roanoke, VA 24014Prevention FirstThe costs for preventive care are excluded from your annual benefits maximum. Click here for more informaiton on the Prevention First benefit.Extra Cleanings?Click here for more information and for the Healthy Smile, Healthy You form.
Davis Vision Contact InformationMember Services:1-888-235-3130Website:Client Control Code: 7025Claims Address:Vision Care Processing UnitPO Box 1525Latham, NY 12110
Last Modified on Wednesday at 2:23 PM