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PEP Jan 2002
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Public Employee Press

DC 37 boosts dental coverage 35 percent

BY GREGORY N. HEIRES

DC 37 recently boosted its coverage of dental work for members by 35 percent, the most significant improvement in years.

The increases were implemented Oct. 1. They cover virtually all of the plan’s payments. In setting the new fees, plan trustees took care to raise the amounts for oral surgery, crowns, dentures, bridges and root canals.

“The new fee structure will strengthen our dental plan,” said DC 37 Deputy Administrator Eliot Seide, chair of the Board of Trustees of the DC 37 Health and Security Plan.

Plan Administrator Roslyn Yasser said that in recent years, “Members have found that fees were too low, and we are responding to their concerns.”

The change should help the plan retain its dentists and encourage more dentists to participate.

The trustees also hiked the calendar year maximum from $1,500 to $1,700 per covered person and raised the lifetime limit on orthodontic treatment from $1,500 to $1,840. Both are based upon the plan's fee schedule and subject to restrictions.

The Plan was able to make the changes in part because of a multi-million-dollar agreement that the city and the municipal unions negotiated a year ago. The agreement provided significant financial relief to union-provided prescription drug benefits, and it helped free up resources for spending in other areas.

Under the DC 37 plan, covered members and retirees may receive their care three ways. They can go to union-run dental centers in Manhattan or Brooklyn. They can see participating dentists, who must agree to accept reimbursement according to the plan’s fee schedule.

Or they may visit private dentists — the path chosen by about half of covered members. The increased payments will reduce the out-of-pocket cost to members who go to private dentists who do not participate in the plan.

The last increase was in 1995, when the fees rose about 20 percent. Following are examples of the new payments:

  • Oral exams now $25; previously $15.

  • Fillings: depending upon complexity, now from $30 to $50; were $11 to $29.

  • Root canals: now $150 to $300; up from $100 to $190.

  • Extensive gum surgery: now $150 per quadrant; was $120.

  • Denture work: now $300 and $325; was $240 and $285.

  • Oral surgery: now from $35 for a routine extraction (was $25) and $175 for a difficult extraction (was $90).

  • Panoramic X-ray: now $40; was $25.




 
 
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