Individuals enrolled in Apple Health (Medicaid), Public Employees Benefits Board, and School Employees Benefits Board coverage - and those accessing behavioral health services - will not experience a disruption in care due to the federal government shutdown. In addition, health care providers will continue to be paid for the services they provide. We will continue to monitor the situation closely and share updates if anything changes.
Find information on the open enrollment page that’s right for you: PEBB retirees, PEBB employees and PEBB continuation coverage subscribers, and SEBB employees and SEBB continuation coverage subscribers.
There are three PEBB Program dental plans to choose from — two managed care plans and one preferred-provider plan. Make sure you check with the plan to see if the dental provider you want is in the plan’s network.
Before you enroll in a dental plans, use the Dental Benefits Comparison to see how benefits compare. For information on specific benefits and exclusions, refer to the dental plan’s certificate of coverage or contact the plan. All dental plans include a nonduplication of benefits clause, which applies when you have dental coverage under more than one account.
Uniform Dental Plan is a preferred-provider organization (PPO) plan and offers a tiered network of providers throughout the United States. You can choose any dental provider, and change providers at any time.
When you see a provider in the Delta Dental PPO network, you maximize your coverage for services. A second tier of providers, the Delta Dental Premier network, is also available and considered in-network. Providers in the Premier network charge a higher coinsurance for covered services.
You pay a percentage of the plan’s allowed amount (coinsurance) for dental services after you have met the annual deductible. Uniform Dental Plan pays up to an annual maximum of $1,750 for covered benefits for each enrolled family member, including preventive visits. Uniform Dental Plan is administered by Delta Dental of Washington.
DeltaCare is a managed-care plan. You must select and receive care from a primary care dental provider in the DeltaCare network. Referrals are required from your primary care dental provider to see a specialist. If you choose this plan and seek services from a dentist not in the plan's network, the plan will not pay your dental claims. Before enrolling, call the plan to make sure your dentist is in the plan's network. DeltaCare is administered by Delta Dental of Washington.
You pay a set amount (copay) when you receive dental services. The plan does not have an annual deductible. You don’t need to track how much you have paid out-of-pocket before the plan begins covering benefits. The plan does not have an annual maximum that they pay for covered benefits (some specific exceptions apply).
You may change providers in your plan’s network at any time. The DeltaCare service area is limited to Washington State.
Willamette Dental is a managed-care plan. You must select and receive care from a primary care dental provider in the Willamette Dental network. You will choose a dentist in one of the Willamette Dental offices to coordinate your care. Referrals are required from your primary care dental provider to see a specialist. If you choose this plan and seek services from a dentist not in the plan's network, the plan will not pay your dental claims. Except for limited out of area emergency services, out-of-network services are not covered. Before enrolling, call the plan to make sure your dentist is in the plan's network. Willamette Dental is administered by Willamette Dental of Washington, Inc.
You pay a set amount (copay) when you receive dental services. The plan does not have an annual deductible. You don’t need to track how much you have paid out-of-pocket before the plan begins covering benefits. The plan does not have an annual maximum that they pay for covered benefits (some specific exceptions apply).
You may change providers in your plan’s network at any time. Offices are located in Washington, Oregon, and Idaho.
You may see any dental provider, but you'll usually pay less out-of-pocket if you go to a provider in the Delta Dental PPO network.
A second tier of providers, the Delta Dental Premier network, is also considered in-network. Providers in the premier network charge a higher coinsurance for covered services.
If you see an out-of-network provider, you'll be responsible for having them complete and sign a claim form.
You may only see providers in the DeltaCare network. You'll have a primary care provider who oversees your care, and authorizes specialist referrals. If the provider you select is not in DeltaCare's network, you will be responsible for the costs. Keep in mind, DeltaCare's service area is limited to Washington State.
You may only see providers in the Willamette Dental network. You'll have a primary care provider who oversees your care, and authorizes specialist referrals. If you see an out-of-network provider, you'll be responsible for the costs. Keep in mind, Willamette has offices in Washington, Oregon, and Idaho.
Preauthorization is when you seek approval from your health plan for coverage of specific services, supplies, or drugs before receiving them. Some services or treatments (except emergencies) may require preauthorization before the plan pays for them. Preauthorization is not a guarantee, however, that your plan will pay for those services, supplies, or drugs.
These criteria do not imply or guarantee approval. Please check with your plan to ensure coverage. Preauthorization requirements are only valid for the month published. They may have changed from previous months and may change in future months.