Basic Dental Benefit Summary



Basic Dental Benefit Summary

Basic Dental Plan Benefit Summary
How the plan works:
    • All Care is covered at 100% up to $175 (deductible waived)
    • Then all other dental expenses (except cosmetic care) is covered at 50% after the $75 deductible
    • No Orthodontic care is covered
    • The maximum benefit per person is $750 from January 1 through December 31, each year
    • You may use the dental care provider of your choice
How to file a claim and receive reimbursement:
    • The itemized bill is mailed or faxed to Direct Reimbursement along with a claim form.
      Fax # 770-683-1099
      Mailing Address: Direct Reimbursement Benefit Plans
      PO Box 71549
      Newnan, GA 30271
    • Proof of student status (ages 19 through 25 must be submitted with the claim form if full-time student.)
    • Benefit checks will be made payable to you and mailed to your home.
    • Please note that if you have a medical Flexible Spending Account through GCPS, when you submit your claim, any out-of-pocket expenses will be automatically distributed out of your Flexible Spending Account. You cannot use your Flex Card to pay for dental expenses and get reimbursement from Direct Reimbursement.