Minnesota Senior Federation
Personal Dental Plans through HealthPartners
Last Updated 5/21/07

1. Who is eligible for the MnSF Dental Plan with HealthPartners?
   *  Legal resident of Minnesota
   *  A Minnesota Senior Federation (MnSF) member within 90 days of joining the Federation (anyone can join the MnSF)
   *  Age 50 or over
   *  Have Medical Insurance (Medicare qualifies, as does Minnesota Care)
   *  You can’t have Medical Assistance (Medical Assistance already covers dental, and eliminated the $600 annual dental limit for ’07)
    
2. When can MnSF members who missed their initial enrollment deadline join the Dental Plan?
    * People who were Federation members prior to February 9, 2007 had until May 9, 2007 to enroll in the Dental Plan. 
     * After February 9, new Federation members must enroll within 90 days of becoming a Senior Federation member.
     * MnSF members who missed their initial enrollment deadline for the Dental Plan will need to wait until the next open enrollment, which will be sometime around July of 2009 at the very earliest.
     * Exception:  If you are a MnSF member who did not enroll the Dental Plan when first eligible because you had other similar dental coverage, but since then you lost that coverage due to no fault of your own, you may enroll in the MnSF Dental Plan with HealthPartners within 90 days of the termination of your previous coverage (if you are otherwise eligible).
3. What’s the difference between the 3 plans?
     * Major Plan:  Designed for seniors who have some preventive coverage as part of their Medicare health supplement (Cost or Advantage plans), so it doesn’t cover preventive. This plan has lowest premium, so it also works for those on a tight budget who are looking to insure against the bigger-ticket, least predictable dental costs.
     * Maintenance Plan:  Designed for people who don’t think they will have much need for extensive future dental work, and want to cover just preventive and a few fillings.
    * Comprehensive plan combines the first two.
4. What is a “PPO”?
    * All three plans are Preferred Provider Option (PPO) plans.  Higher benefits paid for using preferred, in-network dental providers.  But, there’s a lower level of benefits for people who want to use a dentist who isn’t in either of the two preferred networks; this lower level of benefits is called “out-of-network” (means “no network”).  
5. What is a “network”, and why do I have to choose a network in addition to choosing a Plan?
    * A network is a list of dentists who have agreed to accept HealthPartners fees and other terms, and who will file your claims for you. When you enroll, you must choose one of the two provider networks to use as your in-network choice: HealthPartners Dental Group Clinics (Twin Cities and St Cloud), or Open Access Network (entire state). 
    * If you’re in greater MN, you must choose the Open Access network to use for your in-network benefits.  
    * If in the Twin Cities or St Cloud, call HealthPartners to find out which network your own dentist is in, and choose that network.
    * If you are not satisfied, you can change to the other network just before our dental plan with Health Partners renews on July 1, 2008. 
6. Why do I have to choose a dental provider network to use if I’ve decided to only use a dentist who doesn’t belong to either network?
    * The premium is based on which network you choose to go with your Plan choice.  If your dentist isn’t in either network and you’ve decided to only use your own dentist, then choose the Health Partners Dental Group because it’s the lower premium (if your dentist is non-network, you won’t be getting full benefits from the plan anyway).
7. Are there any services that are not subject to the deductible?
    * Preventive care and sealants are not subject to the deductible.
8. If I use up my annual maximum dollar amount for In-network services, can I then see a dentist who isn’t in either of the networks and have more dental work?
    * No.  In-network services count toward meeting the out-of-network maximum as well as the in-network maximum, and vice versa.
9. In the Major and Comprehensive Plans, why do I have to wait 6 months before I can have major oral surgery or surgical periodontics done; and why do I have to wait a whole year for crowns, bridges, dentures, and their repairs?  Do I have to pay the premiums while I’m waiting?  Is there any way to waive the 6 or 12 months for these services?
    * Since this dental program is a new undertaking for the MnSF, we want to ease into this.  If a lot of people were to enroll just to have these expensive services done right away the first year, HealthPartners might pay out more than has been accounted for in the premium amounts.  That would cause such large premium increases for the second year of the program that most of our members would drop out and go to other dental plans.  Having high premiums compared to the other available dental plans on the market would probably cause our plan to shut down, leaving seniors in MN right back where we started:  with very limited, higher priced, lower benefit choices for their dental insurance needs.
    * Yes, you have to pay the premiums while you’re waiting.  The other benefits are available to you during the first year, and you can’t stay in the program to finish up the waiting period if you don’t pay the premiums.  People who have had similar coverage to the Major or Comprehensive dental plan within 3 months prior to joining the our dental plan will not have waiting periods for the expensive services.
10. I read that if I join the dental plan and then I cancel coverage, I have to wait 2 years before I can re-enroll.  Why is that?
    * The dental plan is set up to discourage people from enrolling to get needed dental work done and then canceling coverage right away.  Dental insurance isn’t something to be turned on only when you need to use it.  An even flow of incoming premiums helps to minimize the premium increases for everyone in future years.
11. My dentist says I need to have 3 teeth cleanings per year, but the “Summary of Benefits” says that cleanings are limited to twice per      year.  Does that mean that one of my three cleanings per year will not be paid by the plan at all?                                                                                                  * Yes.  You will have to pay for 1 of your 3 teeth cleanings.
12. I see that there are some limitations that apply to ‘repair, rebase and relining of dentures’.  What are the limitations?
    * This service may be performed once within a certain number of years.  Call the HealthPartners Individual Sales department to find out the exact number of years.
13. I have already purchased the dental rider that is available through my individual Medicare Advantage or Cost plan for 2007.  May I drop it and join the MnSF dental plan?  If yes, what would be the advantage of doing that?                                                                                                 * You may only join the MnSF Dental Plan if you are otherwise eligible (within 90 days of becoming a new MnSF member).  If you are past the 90 days, you may only join the MnSF Dental Plan if you lose your current coverage through no fault of your own.
    *  If you are still within your first 90 days of MnSF membership (so that joining the MnSF Dental Plan is still an option), and your optional dental coverage is with one of HealthPartners individual Medicare products, you may drop it mid-year.  However, if you decide you want to get it back, you will have to wait 2 years.  If you have optional dental coverage with a different health plan, you'll have to call the health plan to find out.
    *  The advantages or disadvantages of switching to the MnSF dental plan will vary depending upon which optional dental rider you have purchased with your Medicare Advantage/Cost plan.  Some of them have no waiting periods for the more expensive dental services, so dropping your other dental coverage may be a disadvantage in that instance.  However, many do not reimburse any services at any more than 50%, except for preventive services, so switching to the MnSF plan would be better.  For most, the dental provider network choices in the Medicare Advantage plans are more limited.  They have different annual maximum benefits - some are higher than the MnSF and some are lower.  Be sure to compare carefully before making a decision to drop the dental option you have now. 
14. What are the other options for dental insurance for seniors in MN? 
    AARP now has a dental plan in MN – we have comparison chart, and it shows that AARP has a higher premium than the MnSF plan.  Delta Dental has “Singular Dental” which is very reasonable, but its enrollment is only open in December every year.  It has a smaller provider network, and provides much less coverage.  Dental discount plans are available for people who use the Internet for enrollment and communication; they tend to have low reimbursement rates and a limited number of participating dentists available.
15. How do I enroll? 
    Call HealthPartners to get a brochure and enrollment form.  952-883-5600, or 1-800-247-7015, option 2 for Individual Sales.  This department can also answer questions you have about the plan.  

Approximate sample prices with no insurance:  
Exam: $45
Cleaning:  $100
Crown:  $1000