The SC State Dental Plan has two options for dental coverage: Dental Plus or Basic Dental (formerly known as the State Dental Plan). When you make your election, you’ll choose either Dental Plus or Basic Dental, not both. If you choose Dental Plus, you will be automatically enroll you in both plans. Dental Plus pays more and has higher premiums and lower out of-pocket costs. Basic Dental pays less and has lower premiums and higher out-of-pocket costs. Changes to existing dental coverage can be made only during open enrollment in odd-numbered years.
Basic Dental has lower allowed amounts, which are the maximum amounts allowed by the plan for a covered service. There is no network for Basic Dental; therefore, providers can charge you for the difference in their cost and the allowed amount. Basic Dental benefits are paid based on the allowed amounts for each dental procedure listed in the Plan’s Dental Procedures Allowed Amounts.
Dental Plus has higher allowed amounts, which are the maximum amounts allowed by the Plan for a covered service. Dental Plus Network providers cannot charge you for the difference in their cost and the allowed amount. Our Beaufort, SC general dentist office is in the Dental Plus Network.
Enrollment in Dental Plus and Basic Dental:
• During initial enrollment in PEBA’s insurance programs.
• During an open enrollment period in an odd-numbered year. The next two opportunities will be October 2021 and October 2023.
• Within 31 days of a special eligibility situation.
Classes of treatment
Dental coverage offers four classes of treatment.
• Class I – Diagnostic and preventive: Exams, teeth cleanings, scaling and root planing, fluoride treatment, space maintainers (child), X-rays.
• Class II – Basic Fillings: extractions, oral surgery, endodontics (root canals), periodontal procedures.
• Class III – Prosthodontics: Onlays, crowns, bridges, dentures, dental implants, repair of prosthodontic appliances.
• Class IV – Orthodontics Limited to covered children ages 18 and younger. Correction of malocclusion consisting of diagnostic services (including models, X-rays) and active treatment (including necessary appliances).