There's a lot of excitement about the Senior Federation's new dental program through HealthPartners. If you are a Minnesota resident, a Minnesota Senior Federation member and have Medicare or other medical insurance, you are eligible to enroll. But dental programs can seem complex. How do you decide which one is right for you? Here are some steps to help you decide. Remember, if you are a current Minnesota Senior Federation member without dental insurance, you need to enroll by March 31, 2007.

Which of the three plans to choose: 

Step 1. Some of the Medicare Cost or Advantage health plans include some coverage for preventive dental care. Check with your health plan to see if you already have some preventive coverage. If you do, then you will probably want to choose the Major Plan. It covers root canals, dentures, periodontics and the other more expensive dental work, but does not cover routine exams and cleanings. The Major Plan has the lowest monthly premium. 

Step 2: Some people's budgets dictate that they go with the least expensive option. So, even if you don't have any preventive dental insurance, you may want to join the Major Plan because it has the lowest monthly premium. And, it provides reimbursement for those services that are most expensive and least predictable in nature - the services best suited for insurance. Since you will have to pay for your own exams and cleanings, be sure you know how much they will cost.

Step 3. Some people have generally healthy teeth and gums and like the option of having their routine services and occasional small fillings covered. Many of these folks think it's highly unlikely they would ever need a crown, denture, or other expensive item, and they don't want to pay a premium for them. You never know what the future will bring, but if you are one of these people, the Maintenance Plan has been designed with you in mind.

Step 4. The Comprehensive Plan includes everything covered by the Maintenance Plan and the Major Plan. This is for people with no other dental coverage, who like the idea of insuring against the unknown possibility of future expensive dental work (like a broken tooth or periodontal disease), and prefer to pay for their preventive visits as part of their monthly premium.

Which network to pair with your plan

Once you decide on which of the three plans you'd like, you have to choose which provider network to have for your In-Network services. This is where it gets more complicated, but don't give up! 

• Do you live outside of either the Twin Cities Metro Area or St. Cloud? If yes, you will choose the HealthPartners Open Access Network, because that is the network with dentists in greater Minnesota.
• If you are in the Twin Cities Metro Area or St Cloud, you will need to choose between the two networks. Do you currently have a dentist that you like? If so, call HealthPartners at 952/883-5600 or 800/247-7015 to see if he or she is one of the more than 1,700 dentists participating in the HealthPartners Open Access Network in the state, or is in the smaller HealthPartners Dental Group, which includes just the Twin Cities Metro area or St. Cloud. Choose whichever network your dentist belongs to. If your dentist is in either of these, he or she is considered "in-network," and your services will be covered at the higher In-Network reimbursement rate. 

Being "In-Network" means that your dentist has agreed to accept HealthPartners' fees and terms, as well as receiving the higher "In-Network" reimbursement rate in the chart below (less for you to pay).  So, visiting a dentist that does not participate with either the HealthPartners Open Access Network or the HealthPartners Dental Group Network may mean additional charges for you, in addition to the higher deductible and lower payment percentage listed in the "Out-of-Network" column in the chart below.

If your dentist is not in either network but would like to join, you may call HealthPartners at the number at the end of this article to request that they send your dentist information about joining the Open Access Network.

Premiums

Each of the three plans, the Maintenance Plan, the Major Plan and the Comprehensive Plan, have different premiums, ranging from $16.83 to $39.88, depending on which plan you choose and which network you choose for "In-Network" services. Note that if you choose the HealthPartners Dental Group, your premium is lower for each of the three plans, than if you choose the Open Access Network. You will need to choose which network option to pair your Plan with, so HealthPartners knows which of the premiums to bill you. This will be the plan and network option you will stay with until the next opportunity to change, which will be July of 2008. (Here's a tip: If your dentist isn't in either network, and you have decided you will only use your own dentist (and receive the Out-of-Network benefits), you can choose the HealthPartners Dental Group network because it has the lower premium.)

The new dental plan is a Senior Federation member benefit. What if you're not a member? We'd love to have you join us! As long as you are a Minnesota resident and you have Medicare or some other medical insurance, you can enroll in one of our discounted Personal Dental Plans with HealthPartners within 90 days of joining the Federation. So, give us call at 651/645-0261 (877/645-0261) to request a membership application. 

For questions about the dental plan, including finding out if your own dentist participates in one of the two networks, call HealthPartners at 952-883/5600 or 800/247-7015, and follow the phone operator prompt to choose option 2, "Individual Sales" department.

Chart of plans, coverage and premiums