Dental & Orthodontia

Take advantage of the provided annual family allowance that ensures you and your family get the dental and orthodontia care you need. Dental Implants are covered!

If you use a Plan participating dentist (who accepts the Carpenters Dental Schedule of Allowances as payment-in full), you and your eligible dependents will be covered for all dental procedures listed on the Schedule of Allowances, at no out-of-pocket expense, up to an annual family maximum of $2,000 for the 12-month period of November 1 through October 31 (preventive treatment for dependents under the age of 19 are not applied against the family annual benefit). These benefits are not insured and are paid solely by the Plan. You can request a copy without charge of the Schedule of Allowances by contacting the Fund Office.

For a more in-depth explanation of your benefits, please refer to the full Health & Welfare Explanation of Benefits.

Dental & Orthodontia FAQs

What is the frequency that a patient can get a cleaning and perio maintenance?

Every 6 months per procedure code. They do not share a limitation.

What is the annual Dental Allowance?

You are given an annual $2,000.00 FAMILY Maximum that runs from November 1st through October 31st. Children 18 and younger DO NOT reduce the family max unless it is for Orthodontic Reimbursement. Click here to see how the Dental Benefit works.

Do I need a special form to take to my dentist?

No, there is no specific form required. Your dentist may submit their claims on any ADA Claim Form. If you have paid your dentist in full you may submit your original itemized paid receipt to the Fund Office for reimbursement.

Do I have to use a participating Dentist or can I use any Dentist of my choice?

You may go to any dentist of your choice, however a participating provider accepts the Fund’s payment as payment in full for covered services up to your $2,000.00 annual Family Max. Once you have reached your Annual Max, a participating provider will only charge you the amount the Fund would have paid for covered services.

 

When visiting a non-participating provider, the Fund will still make payment but you may be responsible for the difference between the Providers’ charge and the Fund’s allowance. To avoid having to pay a balance, click here for a list of Participating Providers.

How do I find out how much of my Dental Family Max has been used?

Please contact the Fund Office at 215-568-0430 to find out how much of your Family Max has been used.

What is the Orthodontic Benefit for Braces?

Orthodontic has a lifetime maximum of $3,200.00 per person. The Orthodontic allowance is not separate from the Annual Family Max of $2,000; therefore, you must have money available in your Annual Family Max to cover these services. For an example of how the Orthodontic Benefit works, click here.

 

The Fund does not pay the Provider; we reimburse you after payment has been made. It will take at least 2 benefit years to collect the full $3,200.00 for reimbursement. Reimbursement is based on date of payment not date of submission to the Fund Office. If you do not have money available in your Family Max on the date you make payment you cannot submit that receipt again in the next benefit period for reimbursement.

 

Please note, children under the age of 18 do not reduce the Family Max unless it is for Orthodontic reimbursement.

In order to enroll in the Orthodontic Benefit, the Fund Office requires certain documents from your provider. Please ask the provider to submit the following items:

 

-A claim form with your first original paid receipt

-Panoramic x-ray

-A Narrative of the Treatment Plan

 

Adult Orthodontic must be pre-approved by the Fund’s Dental Consultant.

 

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