Graduate Medical Education

Medical College of Wisconsin Affiliated Hospitals, Inc.

Summary of Options

Enrollees in the MCWAH Delta Dental Plan need to choose one of the following two options when completing the Dental Insurance enrollment form:

• The deduction from your paycheck will be the same, no matter which option you chose.
• However, the level of benefits and your ability to choose which dentists to visit will vary depending on which option you chose.
• You can change your option, once per year, during the July open enrollment.

OPTION 1 - FREEDOM OF CHOICE

You can select any dentist at any time. The level of benefits varies, depending on which category of dentists you select a dentist from:

• Delta Dental PPO Dentist (Best Benefits)
• Delta Premier Dentist
• Any other dentist, but benefits are less than for a Delta PPO dentist, and possible balance billing may occur from a dentist other thean those in the Delta PPO and Premier networks.

These choices can be made at the time of service, if you have enrolled in the "Freedom of Choice" Plan.

 OPTION 2 - EXCLUSIVE PROVIDER OPTION (EPO)

Under this option, you are making an election to ONLY utilize the Delta Dental PPO network of dentists.   If you obtain services from a dentist outside of this network, there will be NO Benefits for those services.  These are the only dentists available under the EPO plan. This election must be made for the entire plan year (7/1 to 6/30). 

The advantage to this plan is that you have even Lower Out-of-Pocket Cost for seeing the Delta Dental PPO dentist than you would have under the "Freedom of Choice" Plan.

See "YOUR DENTAL BENEFITS" FOR A MORE DETAILED COMPARISON OF THESE OPTIONS AND THEIR RELATED BENEFITS

You can review dentists that are members of the Delta Dental PPO and Delta Dental Premier networks in the following ways: 

• Listed in Delta's Provider Directory,
• by calling Delta direct at 800–236-3712, 
• On-line at Delta's website www.deltadentalwi.com

Online or Calling provides the most current information.