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PEHT Dental

Dental Insurance: Pioneer Dental - Regence BlueCross/BlueShield (FFS)

The Pioneer Dental plan administered by Regence BlueCross BlueShield allows participants the complete freedom to choose any dentist through a Fee-For-Service (FFS) plan. The Plan pays a percentage of the covered procedure directly to the dentist and the participant pays the remaining balance. This plan has a calendar year deductible to meet before coverage begins, as well as a calendar year maximum limit that the plan will pay for services. Please see contact information on the bottom of the page.

What is covered under my Plan?
Check out your complete summary of dental benefits.

Summary of Benefits and Coverage: Dental
Click the link above to see what the plan covers and the cost.

Where can I find the complete details of my Lewis & Clark group plan?
Please see our summary plan description book.

Where can I find local In-Network care?
Find a convenient Participating Dentist near you.

What is the privacy policy?
Find out about our commitment to maintaining your privacy.

Understanding Your Benefits

The plan will begin to pay benefits for covered services in any calendar year only after your calendar year deductible of $50 per claimant or $150 per family is satisfied. Once you have satisfied any applicable deductible, the Plan pays a percentage of the allowed amount for covered services up to the maximum benefit. When the payment is less than 100%, you pay the remaining percentage.

Please be aware when selecting your dentist that the Plan does not reimburse Dentists for charges above the allowed amount. If you select a Participating Dentist, the Plan will not charge you for any balances for covered services beyond your deductible and/or coinsurance amount.  A Nonparticipating Dentist, however, may bill you for any balances over the payment level of the Plan in addition to any deductible and/or coinsurance amount. You can find a list of Participating Providers by visiting the Regence website or by calling Customer Service at 888-367-2116.

Why Do I Need To Know About UCR?

All participants of this plan will need to understand UCR; as it may affect the reimbursement for services and the additional out-of-pocket charges that they might have to pay. UCR stands for Usual, Customary, and Reasonable:

  • Usual: is the fee that an individual dentist most frequently charges for a specific dental procedure.
  • Customary: is the fee level determined by the administrator of a dental benefit plan from actual fees submitted for a specific dental procedure. This fee establishes the maximum benefit payable for that procedure.
  • Reasonable: is the fee charged by a dentist for a specific dental procedure that has been modified by complications or unusual circumstances.

Therefore, the payment of this plan may differ from the dentist’s usual fee if it is not billed at UCR. UCR fees are determined by the fees dentists charge in various geographic areas and by the population size. Usually the heavily populated areas, where the cost of living is higher, have higher dental fees.

Contact Info:

 

Group #: 60026055

Hours:
6:00 a.m. to 6:00 p.m.

Phone:
888-367-2116

E-mail:
secure contact form

Website:
www.or.regence.com

Check your account:
www.myRegence.com

Claims Address:
Regence BlueCross BlueShield of Oregon
PO Box 30805
Salt Lake City, UT 84130

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