Getting more from UPMC for Life’s dental benefits

UPMC for Life’s PPO plans give members the flexibility to use their dental allowance when visiting an out-of-network dental provider. Members who choose the PPO Rx Choice and PPO Premier plans have out-of-network dental coverage and improved dental benefits like:

• Coverage for both preventive and comprehensive care.
• A comprehensive dental allowance for dental services like fillings, simple tooth extractions, root canals, bridges, crowns, and periodontal work. The PPO Rx Choice plan also includes coverage for dentures, denture repairs, and realignments.
• The UPMC for Life Flex Spend Card, which gives members additional dollars to use on additional dental services that are not covered like teeth whitening and dental implants.

If a UPMC for Life member chooses to see an out-of-network provider, the provider may not bill UPMC for Life directly, the member may have to pay for the visit out of pocket.

If a UPMC for Life member has to pay out of pocket, the member can fill out the Dental Claim Reimbursement Form. Members can find this form on the UPMC for Life website or their MyHealth OnLine account. Once the completed reimbursement form is either faxed or mailed, the member will be reimbursed for their out-of-pocket costs according to their plan benefits up to the dental allowance amount for their plan.

Fax: 412-454-8519

Mail: UPMC Dental Advantage

        Claims Department

        PO Box 1600

        Pittsburgh, PA 15230-1600

The member can also use their Flex Spend Card allowance to pay the balance owed to the provider in addition to the reimbursement they submit to UPMC for Life.

Be sure to mention this valuable benefit to your clients! If you have any questions regarding our dental benefit, please contact your broker manager.

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