Retiree Dental Benefits pay up to $1,000 per calendar year for covered dental services. Following payment of a $50 deductible, covered dental services include 100% coverage for preventive and diagnostic services which include the following: Routine exams (up to two per calendar year) Cleanings (up to two per calendar year) X-rays (bitewings- one per calendar year, full mouth- every six months) Emergency exams & pain relief treatment Following payment of a $50 deductible, covered dental services also include 50% coverage for basic and major restorative services which include the following: Filings (silver (amalgam) and tooth colored (composite) on front teeth) Posterior composites Endodontics and periodontics Oral surgery and general anesthesia (associated with oral surgery) Dentures and bridges Implants Cast restorations- crowns, onlays, post and core Surgical periodontics VISION SPOUSES) Retirees or Spouses who elect Pre-Medicare or Medicare-eligible retiree benefits will be automatically enrolled in the vision benefit. For eye examinations, the Plan pays up to $40 Plan’s per examination in any 12 month period following a $10 copayment. For eyeglasses and contact lenses, the Plan pays up to $150 for prescribed eye glasses, frames and prescribed corrective lenses in any 12 month period after a $20 copayment. Eye care benefits are provided as described in the Schedule of Benefits. Participants should use providers participating in the Eye Med Discount Eye Care Program (1-866-723¬0514). This Program permits you to choose a wide variety of eyeglasses and frames that are paid in full under the vision benefit. Plan’s RETIREES AND The Plan pays Hospice Care charges as shown in the Schedule of Benefits. Hospice care is specialized care for terminally ill patients designed to provide physical and psychological comfort for an individual suffering from a terminal illness and for members of the patient’s family.
Retiree Dental Benefits pay up to $1,000 per calendar year for covered dental services. Following payment of a $50 deductible, covered dental services include 100% coverage for preventive and diagnostic services which include the following: Routine exams (up to two per calendar year) Cleanings (up to two per calendar year) X-rays (bitewings- one per calendar year, full mouth- every six months) Emergency exams & pain relief treatment Following payment of a $50 deductible, covered dental services also include 50% coverage for basic and major restorative services which include the following: Filings (silver (amalgam) and tooth colored (composite) on front teeth) Posterior composites Endodontics and periodontics Oral surgery and general anesthesia (associated with oral surgery) Dentures and bridges Implants Cast restorations- crowns, onlays, post and core Surgical periodontics VISION Retirees or Spouses who elect Pre-Medicare or Medicare-eligible retiree benefits will be automatically enrolled in the Plan’s vision benefit. For eye examinations, the Plan pays up to $40 per examination in any 12 month period following a $10 copayment. For eyeglasses and contact lenses, the Plan pays up to $150 for prescribed eye glasses, frames and prescribed corrective lenses in any 12 month period after a $20 copayment. Eye care benefits are provided as described in the Schedule of Benefits. Participants should use providers participating in the Eye Med Discount Eye Care Program (1-866-723¬0514). This Program permits you to choose a wide variety of eyeglasses and frames that are paid in full under the Plan’s vision benefit. RETIREES AND The Plan pays Hospice Care charges as shown in the Schedule of Benefits. Hospice care is specialized care for terminally ill patients designed to provide physical and psychological comfort for an individual suffering from a terminal illness and for members of the patient’s family. SPOUSES)
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