Full coverage for dental checkupsOral health is an important part of your overall health. Kaiser Foundation Health Plan of Washington has teamed up with Delta Dental of Washington to offer you Delta Dental PPO Plus Premier when you enroll in one of Kaiser Permanente Washington’s Individual Medicare Advantage HMO plans.

Delta Dental’s coverage:

• Lets you choose from a large network of dentists. (Care received outside of our network isn’t covered.)

• Provides full coverage for your semiannual dental checkups.

• Is designed to help make sure that dental health problems are detected early.

How to enroll in dental coverage

You’ll need to choose optional dental on our enrollment form when you select an Individual Medicare Advantage HMO plan.

Learn more and enroll online at kp.org/wa/medicare.

If you are a current member of one of our Individual Medicare health plans, call Member Services at 1-800-901-4600 (TTY 1-800-833-6388 or 711), 8 a.m. to 8 p.m., 7 days a week.

If you are a prospective member, call 1-800-446-8882 (TTY 1-800-833-6388 or 711), 8 a.m. to 8 p.m., 7 days a week.Calling this number with direct you to a licensed sales specialist.

2018 optional dental benefits offered by Delta Dental of Washington

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2018 optional dental benefits Delta Dental of Washington

COST SHARES PLAN #01000

Monthly premium $54 per member*

Deductible $100 per person (waived on preventive and diagnostic care)

Annual benefit maximum $1,500 per member

BENEFIT

Preventive and diagnostic care• Routine exams and cleanings

(two per calendar year)• Fluoride treatment

(two per calendar year)• Periodontal cleanings• Dental X-rays

Covered at 100%You pay $0

Basic dental expenses• Fillings/stainless steel crowns• Oral surgery• Endodontics (i.e., root canal treatment)• Periodontics

Covered at 80%You pay 20%

Major expenses• Crowns, implants, and onlays• Dentures, bridges, and partials• Denture adjustments and relines

Covered at 50%You pay 50%

Kaiser Foundation Health Plan of Washington is an HMO plan with a Medicare contract. Enrollment in Kaiser Permanente depends on contract renewal. This information is not a complete description of benefits. Contact the plan for more information. The provider network may change at any time. You will receive notice when necessary. 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 and any other applicable Medicare premium(s), if not otherwise paid by Medicaid or another third party.